Study On The Correlation Between Basal Artery Hypoplasia And Early Clinical Prognosis Of Patients With Acute Ischemic Stroke

Objective Basilar artery hypoplasia(BAH)is a kind of congenital vascular variation,which means that the diameter of the basilar artery is uniform and slender,and the diameter of the basilar artery is less than 2mm at the level of pons.This artical explore the effect of BAH on the early clinical outcome of patients with acute ischemic stroke.Therefore,it provides an objective basis for the evaluation of early prognosis and guidance of secondary prevention.Methods Consecutive patients of acute cerebral infarction who were admitted to hospital were collected from the department of neurology of the affiliated Hefei hospital of Anhui Medical University from December 2015 to December 2016.All the admission patients were scored with a charge National Institutes of Health Stroke Scale(NIHSS),the modified Rankin scale(mRS)was used to assess the neurologic function of the patients at the time of discharge and 90 d after onset,and 0~2 was defined as a good outcome.According to the difference of mRS score of the patients after discharge and the 90 days after onset,the patients were divided into good outcome group at dischargr and poor outcome group at dischargre,good outcome group at 90 d after onset and poor outcome group at 90 d after onset.Based on whether the diameter of the basilar artery in the level of pons was less than 2mm,the patients were divided into BAH group and non BAH group.Comparison between groups of demographic situation,vascular risk factors,vascular changes,baseline clinical data and laboratory examination,through multivariate logistic regression analysis to study the effect of early clinical prognostic factors.Results In this study,434 patients with acute ischemic stroke were included.we excluded patients with incomplete clinical data,acute cerebral infarction was present in both anterior and posterior circulation,basal arterial segmental stenosis or occlusion affects data measurement,mortality and loss of follow up.Therefore,our study population consisted of 334 patients.222 cases were males,112 cases were females.The mean age of the cases was(67.3±12.0)years,There were 28 cases in BAH group,and the remaining 306 were non-bah group.There were 260 patients with good prognosis and 74 patients with poor prognosis at discharge.There were 258 patients with good prognosis and 76 patients with poor prognosis at 90 d after onset.During the follow-up period,11 cases of death and 5 stroke recurrence were reported in BAH group,and no recurrence of death and stroke in BAH group.1.Prognosis of discharge:Single factor analysis showed that the level of age(P=0.010),baseline NIHSS score(P=0.000)and fasting blood glucose(P=0.009)in the poor outcomen group were significantly higher than those in the good outcome group at discharge,the proportion of patients with atrial fibrillation(P=0.011),anterior circulation infarction(P=0.008)and non-BAH(P=0.046)in the poor outcomen group was significantly higher than those in the good outcome group at discharge.Multifacror logistic regression analysis showd that the higher baseline NIHSS scores(OR=1.170,95%CI:1.088~1.258,P<0.01)and fasting blood glucose(OR=1.155,95%CI:1.049~1.272,P<0.05)were the independent risk factors for poor outcomes in patients with acute ischemic stroke at discharge.BAH(OR=0.190,95%CI: 0.039~0.920,P<0.05)was an independent predictor for good outcome of the patient's at discharge.2.Prognosis of 90 days after onset:Single factor analysis showed that the level of age(P=0.010),fasting blood glucose(P=0.009),low density lipoprotein cholesterol(P=0.039)and baseline NIHSS score(P < 0.001)in the poor outcome group were significantly higher than those in the good outcome group at 90 d after onset,the proportion of patients with smoking(P=0.004),atrial fibrillation(P=0.003),anterior circulation infarction(P=0.011),and non-BAH(P=0.040)in the poor outcomen group was significantly higher than those in the good outcome group at 90 d after onset.Multifactor logistic regression analysis showed that the higher baseline NIHSS scores(OR=1.172,95%CI:1.089~1.262,P<0.05)and fasting blood glucose(OR=1.156,95%CI:1.048~1.275,P<0.05)were the independent risk factors for poor outcomes in patients with acute ischemic stroke at 90 days onset.BAH(OR=0.195,95%CI: 0.040~0.940,P<0.05)was an independent predictor for good outcome of the patient's at 90 days onset.Conclusion From our study,we analyzed that the early clinical prognosis of BAH patients after acute ischemic stroke is usually better.BAH is an independent predictor of early clinical prognosis in patients with acute ischemic stroke.And baseline NIHSS score and fasting blood glucose may be predictors of poor prognosis in patients with acute ischemic stroke.