血浆致动脉粥样硬化指数、三酰甘油－葡萄糖指数、脑小血管病影像学标志物对急性缺血性脑卒中患者静脉溶栓早期神经功能恢复的预测价值

doi:10.3969/j.issn.1006-7795.2025.01.008

首都医科大学学报

• 国家卫生健康委加强脑卒中防治工作减少百万新发残疾工程 • 上一篇下一篇

血浆致动脉粥样硬化指数、三酰甘油－葡萄糖指数、脑小血管病影像学标志物对急性缺血性脑卒中患者静脉溶栓早期神经功能恢复的预测价值

杨笑¹, 孟媛媛², 杨靖仪², 王书函¹, 张立功^2*

1.山东第二医科大学临床医学院，山东潍坊 261053；2. 胜利油田中心医院神经内科，山东东营 257034

收稿日期:2024-11-15 出版日期:2025-02-24 发布日期:2025-02-24
通讯作者: 张立功 E-mail:ligongzh@126.com
基金资助:
山东省医药卫生科技面上项目（202303071517）。

Predictive value of atherogenic index of plasma index, triglyceride-glucose index and cerebral small vascular disease imaging markers on early neurological response after intravenous thrombolysis in patients with acute ischemic stroke

Yang Xiao¹, Meng Yuanyuan², Yang Jingyi², Wang Shuhan¹, Zhang Ligong^2*

1.School of Clinical Medicine, Shandong Second Medical University, Weifang 261053, Shandong Province, China; 2. Department of Neurology, Shengli Oilfield Central Hospital, Dongying 257034, Shandong Province, China

Received:2024-11-15 Online:2025-02-24 Published:2025-02-24
Supported by:
This study was supported by Shandong Medical Health Science and Technology Surface Project（202303071517）.

摘要/Abstract

摘要： 目的本研究旨在探究血浆致动脉粥样硬化指数（atherogenic index of plasma, AIP）、三酰甘油－葡萄糖（triglyceride-glucose, TyG）指数、脑小血管病（cerebral small vascular disease，CSVD）影像负荷评分对静脉溶栓后急性缺血性脑卒中（acute ischemic stroke, AIS）患者的早期预后的预测价值。方法选取2022年1月至2023年12月在胜利油田中心医院确诊为AIS且进行静脉溶栓的379例住院患者进行回顾性分析，收集相关资料并进行CSVD影像负荷评分，根据溶栓14 d后AIS患者早期神经功能改善率分为预后良好组（≧18%）和预后不良组（<18%），应用二元Logistic回归分析影响患者早期预后的独立危险因素。采用受试者工作特征（receiver operating characteristic, ROC）曲线分析，评估静脉溶栓的患者早期预后的预测价值。结果收缩压、AIP指数、TyG指数、中性粒细胞与淋巴细胞比值（neutrophil to lymphocyte ratio, NLR）、脑微出血（cerebral microbleeds, CMB）、血管周围间隙扩大（enlarged perivascular spaces, EPVS）、CSVD影像负荷评分≧2分（P<0.05）是影响AIS溶栓患者的早期预后的独立危险因素；ROC曲线显示：CSVD影像负荷评分曲线下面积（area under the curve, AUC）为0.821，灵敏度为80.4%，特异度为74%；AIP AUC为0.951，灵敏度为89.2%，特异度为91.7%；TyG指数AUC为0.918，灵敏度为93.1%，特异度为82.7% 结论 AIP、TyG指数、CSVD影像负荷评分可作为评价静脉溶栓后AIS患者早期预后的有效工具。

关键词: 急性缺血性脑卒中, 早期预后, 血浆致动脉粥样硬化指数, 三酰甘油－葡萄糖指数, 脑小血管病影像负荷

Abstract: Objective To explore the predictive value of the atherogenic index of plasma (AIP), triglyceride-glucose (TyG) index, and cerebral small vascular disease (CSVD) imaging load score regarding the early prognosis of patients with acute ischemic stroke (AIS) after intravenous thrombolysis. Methods A total of 379 inpatients diagnosed with AIS at the Shengli Oilfield Central Hospital and treated with intravenous thrombolysis from January 2022 to December 2023 were retrospectively analyzed. Relevant data were collected, and the CSVD imaging load score was evaluated. The patients were classified into the good prognosis group (≥18%) and the poor prognosis group (<18%) based on the early neurological improvement rate 14 d after thrombolysis. An investigation into the independent risk factors influencing the early prognostic outcomes in patients suffering from AIS was conducted utilizing binary Logistic regression analysis. The efficacy of early prognosis prediction in patients undergoing intravenous thrombolysis was assessed through receiver operating characteristic (ROC) curve analysis. Results Systolic blood pressure, AIP , TyG index , neutrophil to lymphocyte ratio (NLR), cerebral microbleeds (CMB), enlarged perivascular spaces (EPVS) and a CSVD imaging load score of 2 points or higher served as independent risk factors influencing the early prognosis in AIS patients undergoing thrombolysis. The ROC curve analysis revealed that the area under the curve (AUC) for the CSVD imaging load score was 0.821, with a sensitivity of 80.4% and a specificity of 74%. The AUC of the AIP was 0.951, with a sensitivity of 89.2% and a specificity of 91.7%. The AUC of the TyG index was 0.918, with a sensitivity of 93.1% and a specificity of 82.7%. Conclusions The AIP , TyG index , and CSVD imaging load score serve as efficacious indicators in assessing the premature prognostication of AIS patients who underwent subsequently to intravenous thrombolytic therapy.

Key words: acute ischemic stroke, early prognosis, atherogenic index of plasma, triglyceride-glucose index, small vascular disease imaging burden

中图分类号:

R743

杨笑, 孟媛媛, 杨靖仪, 王书函, 张立功. 血浆致动脉粥样硬化指数、三酰甘油－葡萄糖指数、脑小血管病影像学标志物对急性缺血性脑卒中患者静脉溶栓早期神经功能恢复的预测价值 [J]. 首都医科大学学报, doi: 10.3969/j.issn.1006-7795.2025.01.008.

Yang Xiao, Meng Yuanyuan, Yang Jingyi, Wang Shuhan, Zhang Ligong. Predictive value of atherogenic index of plasma index, triglyceride-glucose index and cerebral small vascular disease imaging markers on early neurological response after intravenous thrombolysis in patients with acute ischemic stroke[J]. Journal of Capital Medical University, doi: 10.3969/j.issn.1006-7795.2025.01.008.

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血浆致动脉粥样硬化指数、三酰甘油－葡萄糖指数、脑小血管病影像学标志物对急性缺血性脑卒中患者静脉溶栓早期神经功能恢复的预测价值

Predictive value of atherogenic index of plasma index, triglyceride-glucose index and cerebral small vascular disease imaging markers on early neurological response after intravenous thrombolysis in patients with acute ischemic stroke

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