Systemic inflammatory response index, systemic immune-inflammatory index, and CT perfusion imaging parameters predict early neurological deterioration in patients with minor stroke due to anterior circulation large vessel occlusion
10.3760/cma.j.issn.1673-4165.2024.06.002
- VernacularTitle:全身炎症反应指数、全身免疫炎症指数和CT灌注成像参数预测前循环大血管闭塞所致轻型卒中患者的早期神经功能恶化
- Author:
Hu HUANG
1
;
Zhiwei LIU
;
Zihan YU
;
Chunjie SONG
;
Dan LI
;
Yuanyuan HAN
Author Information
1. 宿迁市第一人民医院介入放射科，宿迁 223800
- Keywords:
Ischemic stroke;
Arterial occlusive diseases;
Severity of illness index;
Inflammation;
Perfusion imaging;
Tomography, x-ray computed;
CT perfusion imaging;
C
- From:
International Journal of Cerebrovascular Diseases
2024;32(6):407-413
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the predictive value of systemic inflammatory response index (SIRI), systemic immune-inflammation index (SII), and CT perfusion imaging (CTP) parameters for early neurological deterioration (END) in patients with mild stroke duo to anterior circulation large vessel occlusion.Methods:Patients with minor stroke duo to anterior circulation large vessel occlusion admitted to the First People's Hospital of Suqian from November 2021 to December 2023 were included. Minor stroke was defined as a baseline National Institutes of Health Stroke Scale (NIHSS) score ≤ 5, and END was defined as an increase of ≥ 4 in NIHSS score within 24 hours of admission compared to the baseline. SIRI and SII were calculated based on the findings of blood routine examination. According to CTP at admission, the cerebral blood volume (CBV) index, infarct core volume, and early infarct growth rate (EIGR) were obtained. Multivariate logistic regression analysis was used to determine the independent risk factors for END. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of each predictor on END. Results:A total of 132 patients were included, with 85 males (64.4%) and a median age of 68 years (interquartile range, 58-77 years). Thirty-nine patients (29.5%) experienced END. The baseline NIHSS score, fasting blood glucose, neutrophil count, lymphocyte count, SIRI, SII, infarct core volume, and EIGR in the END group were significantly higher than those in the non-END group, while the CBV index was significantly lower than that in the non-END group (all P<0.05). Multivariate logistic regression analysis showed that SIRI (odds ratio [ OR] 3.672, 95% confidence interval[ CI] 1.838-6.326; P<0.001), SII ( OR 4.824, 95% CI 2.057-7.135; P<0.001), CBV index ( OR 0.968, 95% CI 0.947-0.986; P<0.001), and EIGR ( OR 2.527, 95% CI 1.918-3.589; P<0.001) were the independent predictive factors of END. ROC curve analysis showed that the area under the curves of SIRI, SII, CBV index, and EIGR for predicting END were 0.780 (95% CI 0.692-0.863), 0.798 (95% CI 0.709-0.888), 0.775 (95% CI 0.697-0.853), and 0.772 (95% CI 0.732-0.829), respectively. Conclusion:SIRI, SII, CBV index, and EIGR are the independent predictive factors of END in patients with minor stroke duo to anterior circulation large vessel occlusion, and have certain predictive value for END.
