Study on the relationship between leptomeningeal collateral circulation and the efficacy and outcome of intravenous thrombolysis in patients with acute cerebral infarction ofmiddle cerebral artery
- VernacularTitle:软脑膜侧支循环与大脑中动脉急性脑梗死患者的溶栓疗效及预后的相关性研究
- Author:
Wei WANG
1
;
Lei CAO
1
;
Xueyun LIU
1
Author Information
- Publication Type:Journal Article
- Keywords: Collateral circulation; Stroke; Intravenous thrombolysis; Thrombolytic efficacy; Outcome
- From: Journal of Apoplexy and Nervous Diseases 2022;39(5):400-404
- CountryChina
- Language:Chinese
- Abstract: To explore the correlation between leptomeningeal collateral circulation and efficacy and outcome of intravenous thrombolysis in patients with acute cerebral infarction of middle cerebral artery. Methods The clinical and imaging data of 136 patients with acute cerebral infarction of middle cerebral artery who received intravenous thrombolysis in the Second Affiliated Hospital of Anhui Medical University from January 2019 to December 2020 were retrospective analyzed. They were divided into poor collateral group（0～1 points，n=58） and good collateral group（2～3 points，n=78）. The differences in baseline clinical data，NIHSS score before and after thrombolysis，90 d MRS score after thrombolysis，early neurological deterioration（END），and the incidence of hemorrhage after thrombolysis were analyzed between the two groups. Factors influencing the prognosis of thrombolysis were analyzed by multivariate logistic regression. Receiver operating characteristic（ROC） curve was used to evaluate the prognostic value of collateral circulation score. Results Compared with the group with good collateral，the mean age and prevalence of atrial fibrillation were significantly increased in the poor collateral group，while the rate of thrombolysis and the incidence of good prognosis were significantly decreased （P< 0.01），and there was no significant difference in the incidence of hemorrhage after thrombolysis between the two groups （P> 0.05）. Multivariate logistic regression analysis showed that good collateral circulation was an independent influencing factor for good prognosis of thrombolysis （OR=5.503，95%CI 1.828～16.570，P=0.002）. The area under the ROC curve predicted by collateral circulation score was 0.801（95%CI 0.724～0.865，P< 0.001）. Conclusion Good leptomeningeal collateral circulation can significantly improve the efficacy of thrombolysis in patients with acute cerebral infarction of middle cerebral artery，and improve the prognosis of thrombolysis. The collateral circulation score has a good predictive value for the prognosis of thrombolysis.
- Full text:2024072421541482166Study on the relationship between leptomeningeal collateral circulation and the efficacy and outcome of intravenous thrombolysis in patients with acute cerebral infarction ofmiddle cerebral artery.pdf
