Objective To investigate the relationship between total bilirubin/albumin(B/A)ratio and the severity of acute large vessel occlusion(LVO)stenosis,collateral circulation and neurological prognosis after mechanical thrombectomy.Methods 109 LVO patients(LVO group)who underwent mechanical thrombectomy in our hospital from March 2018 to March 2023 were retrospectively selected.According to the severity of infarcted artery stenosis,they were divided into mild stenosis group(36 cases),moderate stenosis group(45 cases)and severe stenosis group(28 cases).According to the modified American Society of Interventional and Therapeutic Neuroradiology/Interventional Radiology(ASITN/SIR)collateral circulation classification,the patients were divided into the better collateral circulation group(31 cases),the moderate collateral circulation group(49 cases)and the poor collateral circulation group(29 cases).According to mRS score,they were divided into good neurological prognosis group(27 cases)and bad neurological prognosis group(82 cases).In addition,63 patients receiving physical examination in the outpatient physical examination center of our hospital during the same period were selected as the control group.Clinical information and serum direct bilirubin,indirect bilirubin,TBiL and albumin levels before surgery(physical examination day of control group)were collected to calculate the B/A ratio,compare the B/A ratio difference between groups,and analyze the predictive value of B/A ratio for neurological prognosis.Results The ratios of serum indirect bilirubin,TBiL,albumin and B/A in LVO group were lower than those in control group(P<0.05).The ratios of serum indirect bilirubin,TBiL,albumin and B/A in severe stenosis group were lower than those in moderate and mild stenosis group(P<0.05),and the ratios of serum indirect bilirubin,TBiL,albumin and B/A in poor collateral circulation group were lower than those in good collateral circulation group and moderate collateral circulation group(P<0.05).The ratio of serum TBiL,albumin and B/A in the group with poor neurological prognosis were lower than those in the group with good neurological prognosis(P<0.05).The area under the curve of B/A ratio predicting poor neurological prognosis of LVO patients 90 days after mechanical thrombolectomy was 0.870,which was higher than 0.659 and 0.633 of TBiL and albumin(Z=3.647 and 3.838,P<0.05).Conclusion Low serum TBil,albumin levels and B/A ratio in LVO patients are associated with the aggravation of LVO artery stenosis,poor degree of collateral circulation opening and poor degree of neurological prognosis recovery,and THE B/A ratio has A high value in the prediction of neurological prognosis of LVO patients.
Acute large vessel occlusionMechanical thrombectomyCollateral circulationPrognosisB/A
维普
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