Journal of Capital Medical University ›› 2025, Vol. 46 ›› Issue (1): 48-55.doi: 10.3969/j.issn.1006-7795.2025.01.008

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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 Ligong2*   

  1. 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:2025-02-21 Published:2025-02-24
  • Supported by:
    This study was supported by Shandong Medical Health Science and Technology  Surface Project（202303071517）.

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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

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