Relationship between the severity of white matter lesions and poor prognosis of interventional treatment in patients with ischemic cerebrovascular disease
Objective:To explore the relationship between the severity of white matter lesions(WMLs)and poor prog-nosis of interventional treatment in patients with ischemic cerebrovascular disease.Methods:A total of 102 patients with ischemic cerebrovascular disease were selected as the research objects.The general data and clinical indicators of the patients were collected,and the patients were divided into poor prognosis group(n=43)and good prognosis group(n=59)according to the prognosis of patients after interventional therapy.The independent risk factors influencing the prognosis of patients were analyzed by univariate and multivariate analysis,and the relationship between WMLs and prognosis was explored by fitting curve and correlation analysis.The nomograph prediction model was constructed according to the influen-cing factors,and the model was verified.Results:The poor prognosis group had a higher mean age,a larger proportion of patients with diabetes and hyperlipidemia,and higher values of body mass index(BMI),National Institute of Health Stroke Scale(NIHSS)before treatment,NIHSS immediately after treatment,mean arterial pressure(MAP)24 h postoperatively,WMLs score,high-sensitivity C-reactive protein(hs-CRP),interleukin(IL)-1,IL-6,IL-8,uric acid(UA),serum creati-nine(Scr),and glycosylated hemoglobin(HbA1c)than the good prognosis group(all P＜0.05).Multivariate Cox regres-sion analysis revealed that NIHSS immediately after treatment,WMLs score,hs-CRP,and IL-6 were independent risk factors for poor prognosis in patients undergoing interventional therapy(all P＜0.05).Curve fitting showed that the probability of poor prognosis after interventional therapy increased with higher WMLs scores.Pearson correlation analysis indicated a signif-icantly positive correlation between WMLs score and NIHSS immediately after treatment,hs-CRP,and IL-6(all P＜0.05).A nomogram prediction model was constructed using these independent influencing factors,with a concordance index(C-in-dex)of 0.815(95％CI:0.794-0.826)and an area under the receiver operating characteristic(ROC)curve(AUC)of 0.832(95％CI:0.814-0.843),demonstrating good discrimination.Conclusion:The severity of WMLs may be an inde-pendent risk factor of poor prognosis following interventional treatment in patients with ischemic cerebrovascular disease.
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