Model construction and analysis of factors influencing the formation of intracranial branch circulation in patients with acute cerebral infarction

Abstract

Objective To analyze the factors influencing the formation of intracranial branch circulation in patients with acute cerebral infarction (ACI) and to construct a risk factor model. Methods 100 ACI patients admitted to this hospital from July 2020 to December 2021 were included in the study. According to the formation of intracranial branch circulation, the patients were divided into no collateral circulation group (34 cases) and collateral circulation group (66 cases). example). The clinical data of all patients were collected retrospectively. The factors influencing the absence of collateral circulation in ACI patients were analyzed through univariate analysis and multi-factor logistic regression analysis, a risk factor model was established, and a receiver operating characteristic (ROC) curve was drawn to analyze the impact of the risk factor model on the absence of intracranial collateral circulation in ACI patients. predictive value. Results Multivariate Logistic analysis showed that patients with hypertension, smoking history, serum homocysteine (Hcy), whole blood neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), serum Elevated levels of neuron-specific enolase (NSE) are risk factors for patients with ACI without intracranial branch circulation (OR=1.929, 2.361, 2.382, 2.375, 2.275, 2.022, all P<0.05); serum high-density lipoprotein Elevated levels of cholesterol (HDL-C) and basic fibroblast growth factor (bFGF) are protective factors for ACI patients without intracranial branch circulation (OR=0.446, 0.517, both P<0.05). Incorporate the above factors into the risk factor model: logit(P)=-15.173+hypertension×0.657+smoking history×0.859-HDLC×0.807+Hcy×0.868+NLR×0.865+PLR×0.822-bFGF×0.659+NSE×0.704, Draw the ROC curve. The results showed that when logit(P)>15.46, the area under the curve (AUC) was 0.883, the diagnostic sensitivity was 88.0%, and the specificity was 80.0%. Conclusion The failure to establish intracranial branch circulation in ACI patients is closely related to hypertension, smoking history, increased serum Hcy and NSE levels, increased whole blood NLR and PLR levels, and decreased serum HDL-C and bFGF levels. Risk factors can be established based on this. The model has a high value in predicting the absence of intracranial branch circulation in ACI patients, and corresponding intervention strategies can be adopted clinically for high-risk patients to improve their prognosis. [International Journal of Neurology Neurosurgery, 2022, 49(6):13-17]