| Background:Basal artery occlusive stroke is the most serious type of ischemic stroke,with a disability and lethal rate of more than 80%.Although with the development of medical technology,thrombolytic therapy and intravascular interventional therapy are developing rapidly,but the prognosis of BAO patients is still relatively poor,which seriously increases the social and family economic burden.At present,there are still few studies on the early influence factors of acute basilar artery occlusive stroke,and further research is needed.Objective:Acute basilar artery occlusion(BAO)stroke has a very high disability and fatality rate.It is very important to explore its early onset characteristics and factors affecting prognosis.This study adopted early clinical data,imaging characteristics and Laboratory analysis and other analysis are conducted to further explore the early clinical conditions of BAO and related factors that may affect the prognosis,provide help for the prevention and treatment of diseases,and improve the prognosis of patients.Methods:Retrospectively analyze the clinical data of 79 patients with acute basilar artery occlusion diagnosed by 3.0T magnetic resonance(DWI + MRA)from the First Affiliated Hospital of Henan University from September 2016 to December 2019;collect patient medical records: basic patient data The situation includes the state of admission,past history,personal history,clinical manifestations,imaging features,laboratory tests,etc.The study subjects were divided into groups: 1.According to the characteristics of patients 'onset,they were divided into an acute group and a slow-progressing group;2.The vitality of patients was assessed by a modified Rankin score(m RS)followed up for 3 months,and the patients were divided into good prognosis groups(m RS?3 points)and poor prognosis group(m RS> 3 points).SPSS 24.0 software was used for statistical analysis.Categorical variables were expressed in terms of rate or composition ratio.Comparison between groups was performed by ?2 test;mean of continuous variables ± standard deviation()was expressed,and t test was used between groups;the difference was significant Factors were analyzed using logistics regression analysis,and the risk factors affecting the onset of emergency and clinical prognosis were obtained.P < 0.05 think the difference is statistically significantResults:A total of 103 patients were evaluated,of which 6 were excluded due to missing follow-up and 18 were excluded due to incomplete data.Finally,79 patients were included(52 males [65.8%];median [quartile] age was 68 [62-73] years old),46 cases in the good prognosis group(m RS?3),accounting for 58.2%;33 cases in the poor prognosis group(m RS> 3),accounting for 41.8%;18 deaths,accounting for 22.8%.1.Compared with the slow-advance type,the body temperature and systolic blood pressure were higher and the incidence was significantly higher at admission(P <0.05);there was a significant difference between the high NIHSS score and the high Renard DWI score(P <0.001);There was no significant difference in age,hypertension,diabetes,coronary heart disease,history of cerebral infarction and history of tobacco and alcohol,diastolic blood pressure,BMI,etc.(P> 0.05);single factor logistic regression analysis was performed with independent variables of P <0.05,showing the time of admission High NIHSS score,high Renard DWI score,and body temperature were significantly different(P <0.05),and were risk factors for onset and emergency;multivariate logistic regression analysis showed that elevated body temperature was a significant influencing factor for onset and emergency(OR: 5.132;95 % CI: 1.168-22.544).2.Compared with the good prognosis group,the poor prognosis group had a higher incidence of dyskinesia,dysarthria,and consciousness disorder at the early stage of the onset,and the results were statistically significant(P <0.05);body temperature,systolic blood pressure,The NIHSS score and Renard DWI score were significantly higher than the good prognosis group,and the results were statistically significant(P <0.05);in the laboratory examination related data: white blood cell count,neutrophil count,neutrophil percentage,lymphocyte count,The number of monocytes,the number of neutrophils / lymphocytes,the number of lymphocytes / monocytes,the number of platelets / lymphocytes,erythrocyte sedimentation rate,D-dimer,and glycated hemoglobin were significantly higher than the good prognosis group,the difference was significant(P <0.05);the blood potassium level was lower than that of the poor prognosis group,and the results were statistically significant(P <0.05).Multivariate logistic regression analysis showed that a high Renard DWI score(OR: 18.334;95% CI: 1.873-197.412),a higher NIHSS score at admission(OR: 1.310;95% CI: 1.017-1.687),and a temperature ? 37.2 ° C(OR: 28.136;95% CI: 2.812-281.57),ratio of platelet count to lymphocyte count(OR: 0.989;95% CI: 0.979-0.998),erythrocyte sedimentation rate(OR: 1.170;95% CI: 1.069)-1.281),hypokalemia(OR: 0.136;95% CI: 0.026-0.703)and other significant differences(P <0.05),is a significant risk factor for poor prognosis;in addition,the percentage of neutrophils> 70%(OR: 0.128;95% CI: 0.014-1.199),ratio of neutrophil count to lymphocyte count(OR: 1.619;95% CI: 0.982-2.671),increased D-dimer(OR: 1.745;95% CI: 0.970-3.139)has a certain effect on the poor prognosis(P <0.1).Conclusions:1.The increase in body temperature at admission is related to the onset of emergency,and the incidence of poor prognosis is high;2.A high NIHSS score,a NIHSS score ? 21 points,a high Renard DWI score,a Renard DWI score> 3 points at admission suggest a prognosis The possibility of adverse events is high;3.The percentage of neutrophils increases,the ratio of the number of neutrophils to the number of lymphocytes is high,and the ratio of the number of platelets to the number of lymphocytes indicates the possibility of a poor prognosis;4.The increase of erythrocyte sedimentation rate,D Increased dimer may indicate poor prognosis;5.Low serum potassium at admission indicates an increased incidence of poor prognosis. |
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