纤维化指标与急性缺血性脑卒中患者血管内治疗后症状性颅内出血风险的相关性OACSTPCD

Objective To investigate the correlation between fibrosis indicators and the risk of symptomatic intracranial hemorrhage(sICH)after endovascular treatment(EVT)in patients with acute ischemic stroke(AIS).Methods A retrospective study was conducted on 358 AIS patients who received EVT treatment in the Zhongda Hospital Affiliated to Southeast University from March 2018 to April 2023.Within 24 hours of admission,demographic data such as age,gender,body mass index(BMI),blood pressure,past history,occlusive site,stroke severity,FIB-4 index,EVT related information,and postoperative sICH status were collected.The correlation between FIB-4 index and sICH after EVT was analyzed by multivariate Logistic regression.Results According to the critical value of FIB-4 1.30 and 2.67,the patients were divided into three groups:FIB-4<1.30(n=138),FIB-4 1.30-2.67(n=149)and FIB-4>2.67(n=71).There were significant differences in gender,age,BMI,systolic blood pressure,diabetes,hypertension,hyperlipidemia,large vessel occlusion,postoperative sICH,90-day neurological function prognosis and baseline NIHSS score(P<0.05).There were statistically significant differences in hyperlipidemia,FIB-4 score,FIB-4<1.30,and FIB-4>2.67 between patients without and with sICH after surgery(P<0.05).There were statistically significant differences in patients with good neurological function prognosis at 90-day and those with poor neurological function in terms of age,diabetes,baseline NIHSS score,FIB-4 score,FIB-4<1.30 and FIB-4>2.67(P<0.05).The results of multivariate Logistic regression analysis of postoperative sICH showed that hyperlipidemia(OR=4.552,P=0.046,95%CI:1.030-20.108),FIB-4>2.67(OR=0.078,P= 0.001,95%CI:0.017-0.364)were the influencing factors for postoperative sICH in AIS patients undergoing EVT.Multivariate Logistic regression analysis of 90-day neurological prognosis showed that age(OR=1.220,P<0.001,95%CI:1.155-1.288),diabetes(OR=0.763,P=0.037,95%CI:0.418-1.391),baseline NIHSS score(OR=1.121,P<0.001,95%CI:1.061-1.185),FIB-4>2.67(OR=0.603,P=0.107,95%CI:0.325-1.117)were prognostic factors for neurological function in AIS patients 90-day after EVT.Conclusion The FIB-4 index is associated with the risk of sICH after EVT in AIS patients,and can serve as an independent predictor of symptomatic intracranial hemorrhage.It has high cost-effectiveness and predictive accuracy as a parameter,but it cannot be used as an independent predictor of 90-day neurological function prognosis,the relevant data needs to be further validated in prospective multicenter studies.