[1]杨成双,刘圣,梁堃,等.后循环颅内动脉粥样硬化性急性大血管闭塞的早期识别[J].介入放射学杂志,2025,34(01):18-23.
 YANG Chengshuang,LIU Sheng,LIANG Kun,et al.Early identification of posterior circulation acute large vessel occlusion induced by intracranial atherosclerotic stenosis[J].journal interventional radiology,2025,34(01):18-23.
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后循环颅内动脉粥样硬化性急性大血管闭塞的早期识别()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
34
期数:
2025年01
页码:
18-23
栏目:
神经介入
出版日期:
2025-01-22

文章信息/Info

Title:
Early identification of posterior circulation acute large vessel occlusion induced by intracranial atherosclerotic stenosis
作者:
杨成双刘圣梁堃曹月洲赵林波施海彬贾振宇
Author(s):
YANG ChengshuangLIU ShengLIANG KunCAO YuezhouZHAO LinboSHI HaibinJIA Zhenyu.
Department of Emergency,Qinghai Provincial People′s Hospital,Xining,Qinghai Province 810007,China
关键词:
【关键词】急性缺血性脑卒中后循环动脉粥样硬化大血管闭塞预测模型
文献标志码:
A
摘要:
【摘要】目的根据患者临床资料及影像学检查建立简单的临床预测模型,以期术前更方便地识别后循环颅内动脉粥样硬化狭窄导致急性大血管闭塞患者。方法回顾性分析南京医科大学第一附属医院2019年1月至2022年9月后循环急性大血管闭塞血管内介入治疗患者的临床资料。根据术中血管造影结果,将患者分为急性颅内动脉粥样硬化性狭窄(intracranial atherosclerotic stenosis-acute large vessel occlusion,ICAS-LVO)所致大血管闭塞(ICAS-LVO组)和非ICAS所致大血管闭塞(非ICAS-LVO组),将患者的人口学特征、临床病史、影像学资料和实验室检查结果进行单因素和多因素logistic回归分析,建立ICAS-LVO临床预测模型并根据相关参数绘制Nomogram图。结果共计110例后循环急性大血管闭塞血管内治疗患者纳入最终分析。其中51例患者(49.6%)血管闭塞原因是颅内动脉粥样硬化狭窄。与非ICAS-LVO组相比,ICAS-LVO组患者更年轻,伴心房颤动更少,血浆D-二聚体水平更低,最终筛选出3个因素可用于构建ICAS-LVO术前诊断预测模型,包括心房颤动、闭塞部位和侧支循环情况,该模型具有可接受的校准(Hosmer-Lemeshow检验,P=0.562)和良好的识别力(AUC=0.956,95%CI:0.906~0.986)。结论由无心房颤动、闭塞部位为椎动脉V4段及基底动脉近、中段和侧支循环良好3个预测因素构建的ICAS-LVO临床预测模型具有较高的灵敏度和准确性,有助于神经介入医师早期识别ICAS-LVO并制定血管再通治疗策略。

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备注/Memo

备注/Memo:
(收稿日期:2024-01-22)
(本文编辑:茹实)
更新日期/Last Update: 2025-01-22