基于腦白質(zhì)高信號(hào)負(fù)荷和臨床特征的列線圖預(yù)測(cè)急性腦梗死取栓后近期功能預(yù)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

急性腦梗死（acutecerebralinfarct，ACI）是指由于腦血管阻塞導(dǎo)致的腦組織缺血、缺氧和神經(jīng)元功能障礙的一種急性腦血管疾病，其癥狀主要有肢體無力、言語(yǔ)不清等，病情嚴(yán)重會(huì)危及生命[-2]。（剩余6221字）