论文标题
大脑体积：急性缺血性中风后功能结果的重要决定因素
Brain volume: An important determinant of functional outcome after acute ischemic stroke
论文作者
论文摘要
目的：确定急性缺血性中风（AIS）后脑体积是否与功能结果有关。 方法：我们分析了多站点的基于国际医院的MRI基因界面探索（MRI-GENIE）研究（2014年7月1日至2019年3月16日）的临床脑磁共振成像（MRI），该研究在索引中风和功能结果评估中获得。使用改良的Rankin量表（MRS）得分（0-6; 0：无症状; 6死亡）在中风后记录在中风后60-190天之间确定势后结果。在入院期间，记录了人口统计学和其他临床变量，包括急性中风严重程度（以美国国立卫生研究所的中风量表评分来衡量），血管危险因素和病因学中风亚型（中风的病因分类）。 结果：在广义线性模型中，利用912名急性缺血性中风（AIS）患者（65 +/- 15岁，58％的男性，57％的吸烟史和65％的高血压），脑量（每155.1cm^3）与年龄相关（Beta -0.3（Beta -0.3岁）（每年14.4岁），男性性别（Beta -beta），beta -beta（beta）和0.0（beta）和0.0（beta）。在多变量结果模型中，大脑体积是MRS的独立预测因子（beta -0.233），在脑容量较大的人中，长期功能结果的几率降低（OR：0.8，95％CI 0.7-0.9）。 结论：中风时AIS患者的临床MRI量化较大的大脑体积声称是一种保护机制。大脑体积作为预后，保护性生物标志物的作用有可能构建新的研究领域，并提高当前对冲程后恢复机制的了解。
Objective: To determine whether brain volume is associated with functional outcome after acute ischemic stroke (AIS). Methods: We analyzed cross-sectional data of the multi-site, international hospital-based MRI-GENetics Interface Exploration (MRI-GENIE) study (July 1, 2014- March 16, 2019) with clinical brain magnetic resonance imaging (MRI) obtained on admission for index stroke and functional outcome assessment. Post-stroke outcome was determined using the modified Rankin Scale (mRS) score (0-6; 0: asymptomatic; 6 death) recorded between 60-190 days after stroke. Demographics and other clinical variables including acute stroke severity (measured as National Institutes of Health Stroke Scale score), vascular risk factors, and etiologic stroke subtypes (Causative Classification of Stroke) were recorded during index admission. Results: Utilizing the data from 912 acute ischemic stroke (AIS) patients (65+/-15 years of age, 58% male, 57% history of smoking, and 65% hypertensive) in a generalized linear model, brain volume (per 155.1cm^3 ) was associated with age (beta -0.3 (per 14.4 years)), male sex (beta 1.0) and prior stroke (beta -0.2). In the multivariable outcome model, brain volume was an independent predictor of mRS (beta -0.233), with reduced odds of worse long-term functional outcomes (OR: 0.8, 95% CI 0.7-0.9) in those with larger brain volumes. Conclusions: Larger brain volume quantified on clinical MRI of AIS patients at time of stroke purports a protective mechanism. The role of brain volume as a prognostic, protective biomarker has the potential to forge new areas of research and advance current knowledge of mechanisms of post-stroke recovery.
