Objective To investigate the effects of chitinase protein-40(YKL-40)and cysteine proteolytic enzyme-1(Caspase-1)levels and ASPECTS on the prognosis of patients with anterior circulation massive cerebral infarction(MCI)after interventional thrombectomy. Methods Data of 180 patients with anterior circulation MCI who received interventional thrombectomy in The First Hospital of Hebei Medical University from June 2020 to February 2023 were retrospectively analyzed.The patients were divided into the death group(41 cases)and the survival group(139 cases)according to the prognosis 3 months after interventional thrombectomy.Baseline data and YKL-40 and Caspase-1 levels before interventional thrombectomy were compared between the two groups.Cox regression analysis was used to explore the prognostic factors of interventional thrombectomy for MCI.ROC curve analysis was used to assess the efficacy of YKL-40 and Caspase-1 levels and ASPECTS in predicting the prognosis of patients with MCI after interventional thrombectomy. Results The age and infarct area of the death group were higher than those of the survival group,while the ASPECTS were lower(all P＜0.001).Serum YKL-40 level[(141.37±12.40)μg/L vs.(115.05±11.40)μg/L]and Caspase-1 level[(13.05±1.15)ng/L vs.(8.61±0.64)ng/L]in the death group were higher than those in the survival group(all P＜0.001).Cox regression analysis showed that large infarct area(HR 1.011,95％CI 1.001-1.022),high YKL-40 level(HR 1.033,95％CI 1.001-1.066),and high Caspase-1 level(HR 1.576,95％CI 1.264-1.966)were independent risk factors for death after interventional thrombectomy of anterior circulation MCI,while the high ASPECTS(HR 0.887,95％CI 0.794-0.991)was the protective factor for death after interventional thrombectomy of anterior circulation MCI.ROC curve analysis results showed that the combined prediction of serum YKL-40 and Caspase-1 levels and ASPECTS yielded a better predictive accuracy(AUC 0.940,95％CI 0.890-0.990)than any of these three indexes alone in predicting death after interventional thrombectomy of anterior circulation MCI[the AUCwas 0.869(95％CI 0.806-0.933),0.897(95％CI 0.828-0.966),and 0.724(95％CI 0.642-0.806),respectively]. Conclusions YKL-40 and Caspase-1 levels and ASPECTS were closely related to the prognosis of patients with anterior circulation MCI after interventional thrombectomy.Consequently,these indexes could be used as prognostic indicators.

儿童缺血性卒中的发病率低，年发病率约为1/10万，其发病原因多样，目前尚无规范的治疗方法。本文报道1例急诊采用机械取栓术治疗的因心脏黏液瘤引发的急性缺血性卒中患儿。术后24 h美国国立卫生研究院卒中量表评分为9分，术后第3天为0分；无手术相关并发症。因术前未行静脉溶栓治疗，术后第5天即行心房黏液瘤切除术。术后3个月随访，患儿恢复良好。