目的：探究急性脉络膜前动脉（AChA）梗死早期进展及预后的快速预测生物标志物。方法：回顾性 分析104例急性AChA梗死患者的临床资料，比较早期进展组与非进展组、预后良好组与预后不良组在实 验室指标、美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale，NIHSS）评分、改良 Rankin量表（modified Rankin Scale，mRS）评分、临床表现及治疗反应方面的差异。结果：早期进展组患者 的中性粒细胞与淋巴细胞比值（neutrophil-to-lymphocyte ratio，NLR）高于非进展组（P=0.047）。进展组入 院及出院时的NIHSS评分、出院时的mRS评分均显著高于非进展组（均P＜0.001）；预后不良组的C反应蛋 白（C-reactive protein，CRP）高于预后良好组（P=0.034）；进展组和预后不良组以偏瘫为主要表现的患者显 著增多（P=0.022、0.021）。10例（9.6%）接受rt-PA溶栓，无出血并发症，症状均有改善。进展组中，阿加曲班 治疗（9例）与未治疗（10例）相比，出院NIHSS 及mRS评分无显著差异（P=0.431、0.200），2组均无出血事 件。结论：NLR可能是预测无同侧大血管病变的急性 AChA 梗死患者早期进展的潜在生物标志物；CRP 可能可作为预测急性AChA梗死患者短期预后标志物；早期神经功能恶化是AChA梗死患者短期预后的重 要预测指标；rt-PA溶栓治疗安全有效，阿加曲班治疗未显著改善进展组患者的短期预后。

To explore rapid predictive biomarkers for early progression and prognosis in acute anterior choroidal artery (AChA) infarction. Methods: A retrospective analysis was conducted on the clinical data of 104 patients with acute AChA infarction. The laboratory indicators, National Institutes of Health Stroke Scale (NIHSS) scores, modified Rankin Scale (mRS) scores, clinical manifestations, and treatment responses were compared between the early progression and non-progression groups, as well as between the good prognosis and poor prognosis groups. Results: The neutrophil-to-lymphocyte ratio (NLR) in the early progression group was higher than that in the non-progression group (P=0.047). The NIHSS scores at admission and discharge, and the mRS scores at discharge in the progression group were significantly higher than those in the non-progression group (all P<0.001). The C-reactive protein (CRP) level in the poor prognosis group was higher than that in the good prognosis group (P=0.034). Patients presenting with hemiplegia as the main manifestation were significantly more prevalent in the progression and poor prognosis groups (P=0.022, 0.021). Ten patients (9.6%) received rt-PA thrombolysis; no bleeding complications occurred, and symptoms improved in all cases. In the progression group, there were no significant differences in discharge NIHSS and mRS scores between the patients treated with argatroban (n=9) and those untreated (n=10) (P=0.431, 0.200), and no bleeding events occurred in either group. Conclusion: NLR may be a potential biomarker for predicting early progression in patients with acute AChA infarction without ipsilateral large vessel disease; CRP may serve as a marker for predicting the short-term prognosis of these patients; early neurological deterioration is an important predictor of short-term prognosis in AChA infarction patients. rt-PA thrombolytic therapy is safe and effective, while argatroban treatment did not significantly improve the short-term prognosis of patients in the progression group.