大血管闭塞性卒中病人脑白质高信号严重程度与侧支循环的关系

目的探讨急性前循环大血管闭塞性卒中病人的脑白质高信号( WMHs)严重程度与侧支循环状况的关系。方法回顾性纳入 2017年 5月至 2022年 7月徐州医科大学附属医院收治的前循环大血管闭塞并接受血管内机械性血栓切除术治疗的急性缺血性脑卒中病人。根据美国介入和治疗神经放射学学会 /介入放射学学会( ASITN/SIR)侧支循环分级系统将病人分为侧支循环良好及侧支循环不良两组，并采用 Fazekas评分量表评估 WMHs严重程度。采用多因素 logistic回归分析探索 WMHs与前循环大血管闭塞性卒中病人侧支循环的关系。结果共纳入 127例前循环大血管闭塞性卒中病人，年龄( 62.24±13.63)岁，其中侧支循环良好组 56例，侧支循环不良组 71例。单因素分析显示侧支循环不良组美国国立卫生研究院卒中量表( NI HSS)评分［ 16.00(11.00，21.00)分］、脑室旁脑白质高信号( PWMHs)评分［ 2.00(1.00，2.00)分］、深部脑白质高信号( DWMHs)评分［ 2.00(1.00，2.00)分］以及总的脑白质高信号( TWMHs)评分［ 3.00(3.00，4.00)分］高于侧支循环良好组［ 12.00(10.00，17.75)分、 1.00(1.00，2.00)分、 1.00(1.00，2.00)分］(P<0.05)。多因素 logistic回归分析显示， PWMHs评分［ OR=1.79，95%CI:(1.10，2.90)，P=0.019］及 DWMHs评分［ OR=1.63，95%CI:(1.05，2.55)P=0.031］是侧支循环不良的危险因素。结论在急性前循环大血管闭塞性卒中病人中， WMHs的严重程度与侧支循环不良有关。

Correlation between the severity of white matter hyperintensity and collateral circulation in patients with large-vessel occlusive stroke

Objective To investigate the correlation between white matter hyperintensity (WMH) severity and collateral circulationstatus in patients with acute anterior circulation large vessel occlusive stroke. Methods This retrospective study included patientswith acute ischemic stroke admitted to the Affiliated Hospital of Xuzhou Medical University from May 2017 to July 2022 with large vessel occlusion of the anterior circulation who were treated with endovascular mechanical thrombectomy. Patients were divided into twogroups according to the American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) collateral circulation grading system with good collateral circulation and poor collateral circulation, and the severity of WMHs wasassessed using the Fazekas Rating Scale. Multivariate logistic regression analysis was used to explore the correlation between WMHsand collateral circulation in patients with anterior circulation large vessel occlusive stroke.Results A total of 127 patients with anterior circulation large vessel occlusive stroke were included at the age of (62.24±13.63) years, including 56 patients in the good collateralcirculation group and 71 patients in the poor collateral circulation group. Univariate analysis revealed that the National Institutes ofHealth Stroke Scale (NIHSS) score [16.00 (11.00, 21.00) points], paraventricular cerebral white matter high signals (PWMHs) score[2.00 (1.00, 2.00) points], deep cerebral white matter high signals (DWMHs) score [2.00 (1.00, 2.00) points] in the poor collateral circulation group and total cerebral white matter high signals (TWMHs) score [3.00 (3.00, 4.00) points] were greater than those in the groupwith good collateral circulation [12.00 (10.00, 17.75) points, 1.00 (1.00, 2.00) points, 1.00 (1.00, 2.00) points] (P<0.05). Multivariate lo gistic regression analysis revealed that the PWMHs score [OR=1.79, 95% CI: (1.10, 2.90), P=0.019] and DWMHs score [OR=1.63, 95% CI: (1.05, 2.55), P=0.031] were risk factors for collateral circulation malpractice.Conclusion In patients with acute anterior circulation large vessel occlusive stroke, the severity of WMHs was associated with poor collateral circulation.