Relationship Between White Matter Lesion And Short-term Prognosis Of Patients With Acute Cerebral Infarction

Objective and background:Acute cerebral infarction(ACI)is a high incidence of cerebrovascular disease with high morbidity rate and incidence rate.White matter lesions(WML)are one of the imaging findings of cerebral small vessel disease(SVD).In recent years,studies have found that with WML and brain atrophy in patients with acute cerebral hemorrhage cerebral blood flow slowed down,often poor prognosis.This study was to investigate the prognostic significance of WML in patients with ACI by observing the short-term prognosis of ACI patients with WML.Methods:(MRI)images(FLAIR and T2WI)in the Department of Neurology,the First Affiliated Hospital of Anhui Medical University from September 2015 to January2016.The results showed that 40 cases(WML group)of ACI patients with WML,ACI patients without WML were treated as controls,and the vascular risk factors(age,history of hypertension,history of diabetes,history of smoking,past cerebral hemorrhage,history of cerebral infarction,etc.)were analyzed,(NIHSS score),laboratory test indicators(such as glycosylated hemoglobin,creatinine,blood lipid levels,etc.),according to the improved Rankin prognosis scale scale(MRS)results were evaluated in patients with postoperative discharge in January clinical short-term prognosis,0 ~ 2 is divided into good prognosis,3 to 5 points and death for the poor prognosis.The relationship between WML and the short-term prognosis of ACI was analyzed by statistic correlation analysis of white matter lesions and clinical data and short-term prognosis.Results:The WML group(n = 40)and the control group(n = 40)were compared with those in the control group(72.68 ± 8.46 years vs vs 68.75 ± 8.79)compared with the control group(P <0.05)(2.10 ± 0.67 min),P = 0.007],the proportion of recent adverse clinical outcomes was high [22(55.0%)vs 12(P <0.05),and the MRS score was significantly higher 30.0%),P = 0.024].(N = 46)and poor prognosis group(n = 34).The prognosis of the poor group was significantly higher than that of the poor group(68.57 ± 7.32 years vs.vs.(73.62 ± 9.85)(P <0.01),WML prevalence was higher[18(39.1%)vs.22(64.7%),P = 0.034],NIHSS score was higher in the poor prognosis group [(7.71 ± 4.74)vs(3.96 ± 3.18),P = 0.024],the difference was statistically significant.(AUC)was 0.71(95%,CI = 0.59-0.83,P = 0.002),and the AUC of WML was 0.64(P <0.05),and the AUC was 0.64 95% CI(CI): 0.52-0.77,P = 0.032).The AUC of NIHSS was 0.74(95%(CI): 0.63-0.83,P <0.001),the difference was statistically significant;Binary logistic regression analysis WML is associated with a recent prognosis of all ACI patients.WML is a risk factor for recent prognosis in patients with ACI,with an odds ratio of 2.65(1.00-7.09).Conclusions:White matter lesions(WML)are independent risk factors for poor prognosis in patients with ACI and can be used as a reference for assessing the short-term prognosis of patients with ACI.Clinical use of MRI on WML and age,NIHSS score in combination can be more accurate assessment of ACI patients with the short-term prognosis.