| Objective: We mainly aimed to investigate the factors influencing the prognosis of patients with acute ischemic stroke(AIS)after mechanical thrombectomy(MT),to provide scientific evidence for the treatment and management of AIS.Methods: The clinical data of patients with AIS who were treated by MT were collected and followed in the Affiliated Hospital of Guilin medical university from January 2018 to May 2020,patients were divided into high SUA level group and non-high SUA level group according to relevant guidelines,and we would compare their baseline clinical data,operation-related data,good prognosis rate and mortality 90 d after operation were analyzed.According to the modified Rankin Scale(m RS)score,the patients were divided into good prognosis group and poor prognosis group,the two groups were compared respectively and univariate and multivariate Logistic regression analysis were performed to evaluate the relations of degrees of SUA level with prognosis 90 d after MT.The receiver operating curve(ROC)was used to evaluate the impact of the SUA level on the prognosis of AIS patients with MT.Results:(1)Among the 81 patients,55 patients were into the non-high SUA group and 26 patients were into the high SUA group.As compared with patients in the non-high SUA group,patients in the high SUA group had significantly higher SUA level(544.89±93.48 vs.308.82±76.03 μmol/L)and significantly lower 90 d good prognosis rate(26.92%[7/26] vs.54.55%[30/55])P<0.05.(2)Among the 81 patients,37 had good prognosis and 44 had poor prognosis;univariate analysis showed that compare to the good prognosis group,the poor prognosis group had significantly older age(69.75±9.91 vs.61.49±9.65 years old)and statistically higher baseline NIHSS scores(12.86±3.88 vs.10.84±3.97),significantly higher SUA(427.52±145.82 vs.333.54±108.37 μmol/L),and significantly higher proportion of ICA by vascular occlusion site(50.00% [22/44]vs.24.32%[9/37])and higher proportion of times of thrombectomy(3.00[2.00,3.00] vs.2.00[1.00,3.00])and proportion of high SUA level(43.8%[19/44] vs.18.92%[7/37]),significantly higher rate of symptomatic intracranial hemorrhage(s ICH)72 h after MT(38.64% [17/44])vs.5.41% [2/37]),P<0.05;multivariate Logistic regression analysis showed that SUA(OR=1.006,95% CI1.0 ～ 1.012,P=0.038),age(OR=1.134,95% C I 1.046 ～ 1.229,P=0.002),and times of thrombectomy(OR=2.776,95% C I 1.155～6.672,P=0.023),rate of s ICH(OR=1.909,95% C I 1.573 ～ 1.981,P=0.002)were all independent risk factors for poor prognosis 90 d after MT.(3)The optimal cut-off value of SUA for predicting the prognosis of patients in AIS with MT was 264.74 μmol/L,and the area under the ROC curve was 67.6%(95%C I 0.560～0.793),with a specificity of 37.8%,and a sensitivity of 90.9%.Conclusions:(1)AIS patients with SUA >264.74 μmol/L after MT were more likely to have a poor prognosis.(2)SUA level,age,s ICH and times of thrombectomy may be associated with poor prognosis of patients with AIS undergoing mechanical thrombectomy. |
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