基于脑白质高信号负荷和临床特征的列线图预测急性脑梗死取栓后近期功能预后

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[Abstract]Objective：To investigate the factors white mater hyperintensity （WMH） burden and clinical featuresinfluencing short-termfunctionaloutcomeafter thrombectomyinacutecerebral infarction （ACI），and to construct and validatea risk nomogram model basedonthese factors.Method：A total 186 patients who underwent thrombectomy for ACI at Yichun People's Hospital between February 2O20 and October 2O22 were retrospectively recruited.All patients were followedup for3 months to assess outcomes.The total 186 subjects were randomly assigned to either the derivation group （ n⋅n⋅n =130）and the verification group（ n =56）witha7：3distribution.Within the training cohort， patients were categorized into a favorable outcome group （n=67） and a poor outcome group （ n =63） based on prognosis.Arisk nomogram model was constructedand externallyvalidated.Result： Univariate analysis demonstrated statisticallysignificant diferences between the two groups inage，NIHSS score，onset-to-treatment time，infarct volume，hypertension，depression，periventricularFazekas score，and deep Fazekasscore（ P <0.05）. Multivariate logistic regression analysis identified age，NIHSS score，infarct volume，hypertension，depresion， periventricular Fazekasscore，and deepFazekasscoreas independent risk factorsfor poor short-term functional outcomes in ACI （ P <0.05）. The risk nomogram model constructed with these factors exhibited an area under the ROC curve （AUC） O.883，at the optimal cutvalue 0.460，the sensitivityand specificity were 0.841 and 0.776， respectively.Calibrationcurve analysis revealed a mean absolute eror O.O39.Decision curve analysis demonstrated consistent clinical net benefit across threshold probabilities ranging from O to 100% . Conclusion： The nomogram model for ACI prognosis assessment，based on WMH burden and clinical features，exhibits good predictive performance.Itcanaccurately predict short-termfunctional outcomes inACI patients，providing valuable reference forrehabilitation planning and medical resource allocation.

[Keywords] Whitematterhyperintensity Acutecerebral infarction Mechanical thrombectomy

Functional outcome Influencing factorsNomogram

First-author'saddress：NeurosurgeryDepartment YichunPeople'sHospital， Yichun336ooo，China doi：10.3969/j.issn.1674-4985.2025.23.035

急性脑梗死（acutecerebralinfarct，ACI）是指由于脑血管阻塞导致的脑组织缺血、缺氧和神经元功能障碍的一种急性脑血管疾病，其症状主要有肢体无力、言语不清等，病情严重会危及生命[-2]。（剩余6221字）