Study On The Correlation Between Unilateral Fetal-type Posterior Cerebral Artery And The Severity Of Acute Posterior Circulation Infarction

Objective Fetal-type posterior cerebral artery is a common anatomical variant,and its clinical attention is not high in the treatment of acute posterior circulation cerebral infarction.Acute posterior circulation cerebral infarction has a hidden onset and a high mortality and disability rate.At present,there is no in-depth study on the impact of different types of FTP on APCI.This article focuses on exploring the correlation between unilateral embryonic posterior cerebral artery and the severity of acute posterior circulation cerebral infarction.Methods Retrospective collection of 60 patients with acute posterior circulation cerebral infarction,divided into a non FTP group of 20 cases and a unilateral FTP group of 40 cases.The unilateral FTP group was further divided into a unilateral c FTP group of 20 cases and a unilateral p FTP group of 20 cases.In addition,according to the mRS score,the patients were divided into a good prognosis group and a poor prognosis group,and the differences between the two groups were compared.Diffuse weighted imaging(DWI)was used to determine the infarct site,calculate the infarct volume,and record the gender,age,smoking,drinking,diabetes,coronary heart disease,hypertension,hyperlipidemia,hyperhomocysteinemia,NIHSS score,mRS score,and pc-ASPECTS score of each group.The infarct volume is calculated using the Pulicino formula:infarct volume(ml)=maximum transverse diameter × Maximum length diameter ×Number of layers × Layer thickness × π/6 。 Use SPSS 25.0 software for statistical analysis to observe whether there is a difference between the non FTP group and the unilateral FTP group,and then observe whether there is a difference between the non FTP group and the unilateral c FTP group,and the unilateral p FTP group;After obtaining relevant influencing factors between the group with good prognosis and the group with poor prognosis,a multivariate binary logistic regression analysis was conducted.P<0.05 indicates a statistically significant difference.Result1.The proportion of patients with coronary heart disease in the non FTP group was45.00%,significantly higher than the proportion of 17.50% in the unilateral FTP group(χ2= 5.156,p=0.023);The difference in other clinical data between the non FTP group and the unilateral FTP group was not statistically significant.The differences in clinical data between the non FTP group,unilateral c FTP group,and unilateral p FTP group were not statistically significant.3.There was no statistically significant difference in the infarct site between the non FTP group and the unilateral FTP group in acute posterior circulation cerebral infarction.4.The difference in the infarct site of acute posterior circulation cerebral infarction between the non FTP group,unilateral c FTP group,and unilateral p FTP group was not statistically significant.3.The differences in NIHSS score,mRS score,and infarct volume between the non FTP group and the unilateral FTP group were statistically significant.The median of NIHSS score,mRS score,and infarct volume in the unilateral FTP group was higher than that in the non FTP group(p<0.001;p<0.001;p=0.001).The differences in NIHSS score,mRS score,and infarct volume between the non FTP group,unilateral c FTP group,and unilateral p FTP group were statistically significant,with p-values of 0.001,0.001,and 0.002,respectively,all less than 0.05.Compare the NIHSS score,mRS score,and infarct volume of the non FTP group,unilateral c FTP group,and unilateral p FTP group in pairs,and use Bonferroni correction(Significance adjusted to p<0.017).The median NIHSS score and mRS score of the unilateral c FTP group were higher than those of the non FTP group(p=0.001;p=0.002);The median NIHSS score,mRS score,and infarct volume in the unilateral p FTP group were higher than those in the non FTP group(p=0.003;p=0.001;p=0.001).4.mRS≤2 was defined as good prognosis,and mRS>2 was defined as poor prognosis.Differences between the two groups were compared.In the comparison of clinical data,whether there is diabetes has statistical significance(χ2=4.861,p=0.027),78.95% of the poor prognosis group had diabetes,which was higher than 48.78% of the good prognosis group;Statistically significant presence of hyperhomocysteinemia(χ2=6.406,p=0.011),the proportion of patients with hyperhomocysteinemia in the poor prognosis group(57.89%)was significantly higher than that in the good prognosis group(28.38%);Is there a statistically significant presence of unilateral FTP(χ2=9.859,p=0.002),94.74% of patients in the poor prognosis group had unilateral FTP,which was significantly higher than 53.63% in the good prognosis group.In addition,the distribution of c FTP and p FTP was consistent between the two groups.After correcting for related confounding factors,a multivariate binary logistic regression analysis was conducted.It can be seen that there is no statistical significance whether there is diabetes(OR 3.047,95% CI: 0.742~12.522,p=0.122),whether there is hyperhomocysteinemia(OR 3.566,95% CI: 0.975~13.041,p=0.055),and whether there is unilateral FTP(OR 10.338,95% CI: 1.194~89.521,p=0.034),which indicates that unilateral FTP is a risk factor for poor prognosis.Differences in NIHSS score,pc-ASPECTS,and infarct volume were compared between the good and poor prognostic groups.A statistically significant difference in NIHSS score(p<0.001)was observed,with the median of the poor prognosis group(6.00)significantly higher than that of the good prognosis group(2.00).Additionally,there is a significant positive correlation between mRS score and NIHSS score in patients with acute posterior circulation cerebral infarction(rs=0.827,p<0.001).Conclusion 1.The proportion of patients with coronary heart disease in the non FTP group is significantly higher than that in the unilateral FTP group;The differences in other general clinical data between different groups were not statistically significant.2.The differences in the infarct site of acute posterior circulation cerebral infarction between different groups were not statistically significant.3.Compared to non FTP patients,patients with unilateral c FTP and unilateral p FTP experience more severe infarction and poorer prognosis when they die from acute posterior circulation cerebral infarction.4.The prognosis of those with acute posterior circulation infarction is detrimentally affected by unilateral FTP.5.There is a significant positive correlation between mRS score and NIHSS score in patients with acute posterior circulation cerebral infarction,prove the reliability of NIHSS score in evaluating the severity of acute posterior circulation cerebral infarction.