The Relationship of Head and Neck CT Angiography and NIHSS Score with Collateral Circulation and Prognosis of Acute Ischemic Stroke Patients
Objective:To investigate the relationship of head and neck CT angiography(CTA)combined with the national institutes of health stroke scale(NIHSS)score and collateral circulation and prognosis of acute ischemic stroke(AIS)patients.Method:Clinical data of 82 patients with AIS who were treated in Ruijin Hospital of Traditional Chinese Medicine from March 2019 to July 2023 were retrospectively analyzed,all patients received digital subtraction angiography(DSA),CTA and NIHSS score before treatment.Based on DSA results,the patients were grouped into good collateral circulation group and poor collateral circulation group.CTA collateral circulation scores[sylvian fissure+convex surface collateral system score(Maas score)and the collateral system score of the middle cerebral artery(Tan score)],and the NIHSS score between two groups were compared.After intravenous thrombolysis,the patients were divided into a poor prognosis group and a good prognosis group based on the modified Rankin scale(mRS)score.The influencing factors of poor prognosis and the prognostic value of CTA collateral circulation score combined with NIHSS score were analyzed.Result:The DSA examination results showed that among 82 AIS patients,there were 42 cases in the good collateral circulation group and 40 cases in the poor collateral circulation group.The Maas and Tan scores of the patients in the poor collateral circulation group were significantly lower than those in the good collateral circulation group,and the NIHSS score was significantly higher than that in the good collateral circulation group(P<0.05).After thrombolytic therapy,there were 22 patients with poor prognosis and 60 patients with good prognosis in the 82 AIS patients.Univariate analysis found that there were statistically significant differences in Maas,Tan,and NIHSS scores between the poor prognosis group and the good prognosis group(P<0.05).Multivariate analysis showed that Maas score,Tan score,and NIHSS score were all independent influencing factors for poor prognosis in AIS patients(P<0.05).The analysis of the receiver operating characteristic(ROC)curve showed that the AUC(0.915)of CTA examination(Maas score,Tan score)combined with NIHSS score in predicting the prognosis of AIS patients was significantly higher than that of Tan and NIHSS scores(P<0.05).Conclusion:The combination of head and neck CT angiography and NIHSS score can effectively evaluate the collateral circulation and prognosis of AIS patients.The combination of the two can improve the predictive efficacy of thrombolytic therapy for prognosis,and provide reliable information for collateral circulation evaluation and prognosis prediction of AIS patients.
Head and neck CT angiographyNIHSS scoreAcute ischemic strokeCollateral circulationPrognosis
万方数据
维普
