Prognostic Analysis Of Patients With Chronic Cerebrovascular Occlusion

Objective:To observe the prognosis of patients with chronic cerebral vascular occlusion and to analyze the risk factors affecting the prognosis of patients.Methods:According to the inclusion criteria and exclusion criteria,337 patients with cerebral large vessel occlusion confirmed by whole brain angiography in the Department of Neurology,Yantai Yuhuangding Hospital of Qingdao University,Shandong Province from 2010 to2015 were retrospectively collected,including 246 males and females.Cerebral vascular occlusion includes bilateral internal carotid artery and bilateral middle cerebral artery.These patients were diagnosed with a transient ischemic attack(TIA)or were diagnosed with cerebral infarction and the NIHSS score was <5.Collect clinical data of patients,including:(1)demographics,lifestyle risk factors,basic medical history and other data of the subjects;(2)blood routine,blood biochemistry and other test results within 48 hours after admission;(3)according to the results of cerebral angiography were used to evaluate the type and classification of open collateral circulation.All patients were given anti-platelet aggregation,lipid-lowering plaque,scavenging oxygen free radicals,protecting brain mitochondria,improving circulation and other related treatments according to the "China Acute Ischemic Stroke Diagnosis and Treatment Guide 2018".Patients who met the indications for intravenous thrombolysis intravenous thrombolysis is given,and patients who meet the conditions are relatively stable and undergo early rehabilitation exercises.The patients enrolled in the chronic cerebral vascular occlusion were followed up for 4.5(2.8-5.6)years,of which 329 patients completed the follow-up.All follow-up work was completed by a fully trained neurologist.Study information on outcomes and related information.According to the modified Rankin Scale(mRS)score,329 patients were divided into the asymptomatic group(mRS = 0)and the symptomatic group(mRS > 0).Continuous variables were expressed as intermediate variables(interquartile range [IQR]),and categorical variables were expressed as frequency.The SASTA14.0 statistical software was used to compare the asymptomatic group with the symptomatic group.P<0.05 was considered statistically significant.Finally,multivariate analysis was performed using binary stepwise regression to identify possible risk factors for the prognosis of patients with chronic cerebral vascular occlusion.Result:1.Of the 337 patients with chronic cerebrovascular occlusion in this study,8(2.3%)were lost to follow-up,225(66.8%)were in the asymptomatic group,and 104(30.9%)were in the symptomatic group.There were no significant differences in cerebrovascular risk factors such as gender,age,smoking,alcohol consumption,hypertension,diabetes,coronary heart disease,and dyslipidemia.Blood pressure,albumin,platelets,white blood cells,creatinine,urea nitrogen,aspartate aminotransferase,There were no significant differences in the test indicators such as alanine aminotransferase;there was no significant difference in the collateral circulation grading between the two groups.2.In the logistic regression analysis,lower levels of uric acid may be associated with poor patient prognosis(OR: 0.995,CI: 0.992-0.999,P=0.005),collateral circulation blood flow grading and prognosis of patients with cerebral vascular occlusion are positive correlation(OR: 0.392;95% CI: 0.225-0.686;P < 0.05).3.High-density lipoprotein(OR: 4.868,95% CI: 1.808-13.107,P=0.002),history of previous ischemic stroke(OR: 0.581,95% CI: 0.344-0.982,P =0.042)The history of coronary heart disease(OR: 0.494,95% CI: 0.279-0.875,P=0.016)was associated with collateral circulation blood flow grade <4.Conclusion:1.Lower levels of uric acid may be associated with poor prognosis in patients with chronic cerebral vascular occlusion;2.The higher the grade of collateral circulation blood flow,the better the prognosis of patients with chronic cerebral vascular occlusion;3.High-density lipoprotein is beneficial to the formation of collateral circulation of the brain;4.History of previous ischemic stroke and history of coronary heart disease are not conducive to the formation of collateral circulation.