| Objective: We aim to investigate effect factors of establishing collateral circulation in patients with large artery artherosclerosis stroke and the association between collateral circulation status and prognosis.Methods: We examined 211 patients with symptomatic middle cerebral artery(M1)stenosis(diagnosed by MRA,CTA and DSA)acute ischemic stroke who were consecutively admitted to the First Hospital of Chen zhou from August 2015 to December 2017.All patients underwent standardized clinical assessment and cerebral m CTA(including arterial peak phase,venous peak phase,and late venous phase).According to the ASPECTS collateral circulation score(0-5)of m CTA imaging,the collateral circulation score(0-5 points)was used to determine the status of collateral circulation of the m CTA imaging results,and the score of 0-3 points were defined as poor collateral circulation and the score of 0-3 points were defined as good collateral circulation.According to the status of collateral circulation,all the patients were divided into two groups: poor collateral circulation of 85 cases and good collateral circulation 126 cases.Patients' characteristics were summarized for each group separately.Messages including clinical data(age,smoke,hypertension and diabetes),laboratory data including(serum lipid fractions,fibrinogen and homocysteine),score of NIHSS and score of m RS including(3 months and 6 moths)were achieved.We made statistical comparison on between two groups and logistic regression(univariate and multivariable)to identify the relative factors.Then we made statistical comparison the baseline of the scores of NIHSS and the scores of m RS in 3 months and 6 months between two groups.Results:1.With comparisons between 126 cases with good collateral circulation group and 85 cases poor collateral circulation group,the good collateral circulation group of fibrinogen(p=0.009)and systolic pressure(p=0.008)is higher than the poor collateral circulation group;the good collateral circulation group of low-density lipoprotein cholesterol(p<0.001)and homocysteine(p=0.004)is lower than the poor collateral circulation group;there were statistically differences in smoke(p<0.001)and diabetes(p<0.001).There were no significant difference in age,cholesterol,high-density lipioprotein cholesterol,triglyceride and diastolic pressure.2.There were significant difference in age,systolic pressure,diastolic pressure,cholesterol,homocysteine,fibrinogen,diabetes,smoke between two groups by univariate logistic regression(p<0.05).There were no significant difference in high-density lipioprotein cholesterol,triglyceride,low-density lipoprotein cholesterol between two groups.3.Considering patients whether collateral circulation was good or poor as dependent variable,multivariate logistic regression analysis was used to identify age,smoke,systolic pressure,diastolic pressure,diabetes,fibrinogen,cholesterol,low-density lipioprotein cholesterol and homocysteine.the results revealed that systolic pressure(OR=0.595,95%CI 0.854-2.616,p=0.010),diastolic pressure(OR=0.417,95%CI 0.200-0.868,p=0.019),fibrinogen(OR=0.645,95%CI 0.321-1.300,p=0.020)were promoted collateral circulation,age(OR=2.178,95%CI 1.325-3.582,p=0.002),diabetes(OR=1.309,95%CI 0.504-3.398,p<0.001)were restrained for collateral circulation.4.Comparing the scores of NIHSS between two groups,and the results showed that the good collateral circulation group was lower at admission and discharge(p<0.001).Comparing the scores of m RS between two groups,and the results showed that the good collateral circulation group was lower at 3 moths and 6 moths(p < 0.001).Conclusion:1.Systolic pressure,diastolic pressure and high fibrinogen were harmful for collateral circulation establishment.But age and diabetes were benefict to collateral circulation establishment.2.The prognosis of patients with artherosclerosis stroke good collateral circulation group was better than the poor collateral circulation group. |
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