| Objective: To analyze the influencing factors of collateral circulation in patients with acute cerebral infarction with unilateral internal carotid artery occlusion and the relationship between collateral circulation and patient prognosis.Methods: Continuous incorporated in February 2019 to May 2020 in the Yan’an University Hospital of Xianyang line cerebrovascular intervention by cerebral angiography confirmed unilateral carotid artery occlusion 136 patients,Is satisfied in accordance with standard row screened unilateral carotid artery occlusion combined94 cases of acute cerebral infarction.Collect patient’s age,gender,smoking history,drinking history,hypertension,diabetes,long-term exercise,previous oral statins and antiplatelet drugs,as well as the patient’s total cholesterol,low-density lipoprotein cholesterol,triglycerides,uric acid,homocysteine and lipoprotein-related phospholipase A2.Record the American National Stroke Scale(NHISS)scores at the time of admission and 14 days after admission.The modified Rankin(m RS)score of90 days after the onset of patients was followed up by telephone.Two cases were lost to follow-up.The prognosis was good for m RS score ≤2,and poor prognosis was scored for m RS>2.According to the American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology(ASITN/SIR)evaluation system,ASITN/SIR≥3 points were included in the good collateral circulation group,and ASITN/SIR≤2 points were included in the poor collateral circulation group.Use logistic regression to analyze the influencing factors of collateral circulation.The t test and X2 test were used to compare the difference in NHISS score,NHISS score difference(NHISS score at admission minus NHISS score14 days after admission)between the two groups of patients,and the difference in the good prognosis rate of 90 days after onset.Result:1.The study included 94 patients,53 patients in the good collateral circulation group,with an average age of 58.42±11.37 years old,35 males,the proportion was about 66.0%,20 smoking cases,the proportion was about 37.7%,and 18 cases of drinking,the proportion 34.0%,34 cases of oral statin drugs,the proportion of 64.2%,25 cases of oral antiplatelet aggregation drugs,the proportion of 47.2%,27 cases of long-term exercise,the proportion of 50.9%,30 cases of hypertension,the proportion of about 56.6%,14 cases of diabetes,the proportion of about 26.4 %,45 cases had a good prognosis for 90 days after the onset of onset,the proportion was 86.5%;41patients in the poor collateral circulation group,with an average age of 58.98±9.23 years,22 cases were male,the proportion was about 53.7%,10 cases were smoking,the proportion was about 24.3%,and 13 cases were drinking,The proportion was31.7%,14 cases of oral statins,the proportion of 34.1%,oral antiplatelet aggregation drugs 12,the proportion of 29.3%,16 cases of long-term exercise,the proportion of39.0%,20 cases of hypertension,the proportion of about 48.8.%,diabetes 13 Cases,the ratio is about 31.7%,and the prognosis is good in 25 cases,the ratio is 62.5%.2.The single factor logistic regression results showed that lipoprotein-related phospholipase A2,homocysteine,and oral statins were the factors affecting the formation of collateral circulation(P<0.05).These three variables were included in the logistic multivariate regression analysis: high homocysteine is a risk factor for the formation of collateral circulation(β=0.115 0R=1.122,95%CI: 1.032-1.220,P=0.007),while previous oral statins Drugs and lipoprotein-associated phospholipase A2 are factors that promote the formation of collateral circulation(β=-0.949 OR=0.387,95%CI: 0.155-0.966,P=0.042;β=-0.008 OR=0.992,95%CI: 0.984-0.999,P=0.027).3.The NHISS scores of the good collateral circulation group at admission and 14 days after admission were lower than those of the poor collateral circulation group,while the NIHSS score difference was higher than that of the poor collateral circulation group.(5.90±2.41 VS 7.71±2.46,P<0.05;2.02±1.22 VS 4.56±1.67,P<0.05;3.91±1.63 VS 3.12±1.19,P<0.05).4.The 90-day good prognosis rate in the good collateral circulation group was higher than that in the poor collateral circulation group(86.5% VS 62.5%,P<0.05).Conclusion:1.For patients with acute cerebral infarction caused by unilateral internal carotid artery occlusion,lipoprotein-related phospholipase A2 and previous oral statins are the promoting factors for the formation of collateral circulation,and high homocysteine is not conducive to the formation of collateral circulation.2.Good collateral circulation helps to reduce the neurological deficit and promote the recovery of neurological function. |
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