[1]孟飞龙,徐浩文,权 涛,等.急性颅内大血管闭塞机械再通患者预后影响因素分析[J].介入放射学杂志,2020,29(12):1177-1181.
 MENG Feilong,XU Haowen,QUAN Tao,et al.Mechanical recanalization of acute intracranial large vessel occlusion: analysis of prognostic factors[J].journal interventional radiology,2020,29(12):1177-1181.
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急性颅内大血管闭塞机械再通患者预后影响因素分析()

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

卷:
29
期数:
2020年12
页码:
1177-1181
栏目:
神经介入
出版日期:
2020-12-25

文章信息/Info

Title:
Mechanical recanalization of acute intracranial large vessel occlusion: analysis of prognostic factors
作者:
孟飞龙 徐浩文 权 涛 袁永杰 王子博 管 生
Author(s):
MENG Feilong XU Haowen QUAN Tao YUAN Yongjie WANG Zibo GUAN Sheng.
Department of Neurointervention, First Affiliated Hospital of Zhengzhou University, Zhengshou, Henan Province 450052, China
关键词:
【关键词】 脑梗死 大血管闭塞 机械再通 预后 影响因素
文献标志码:
A
摘要:
【摘要】 目的 探讨机械取栓治疗急性颅内大血管闭塞的有效性和安全性及影响预后的相关因素。 方法 回顾性分析2012年1月至2019年7月在郑州大学第一附属医院接受机械取栓治疗的急性颅内大血管闭塞性脑卒中患者临床和影像学资料。根据术后3个月改良Rankin量表(mRS)评分,将337例入组患者分为预后良好组[mRS评分0~2分,188例(55.8%)]和预后不良组[mRS评分3~6分,149例(44.2%)]。分析两组患者年龄、高危因素、入院时美国国立卫生研究院卒中量表(NIHSS)评分、闭塞部位(颈内动脉、大脑中动脉和椎-基底动脉)、发病-股动脉穿刺时间(OTP)、股动脉穿刺-血管再通时间(PTR)、术后即刻再通效果[改良脑梗死溶栓(mTICI)治疗后血流分级]、症状性脑出血[欧洲急性脑卒中协作研究(ECASS)组Ⅱ标准]及术后3个月预后。对预后影响因素进行多因素logistic回归分析。 结果 两组患者年龄、入院NIHSS评分、伴高血压、伴糖尿病、血管闭塞部位比较,差异均有统计学意义(P<0.05);其他基线资料差异均无统计学意义(P>0.05)。大脑中动脉闭塞再通患者预后良好率显著高于颈内动脉、椎-基底动脉闭塞患者(P=0.02)。预后良好组患者OTP、PTR显著短于预后不良组(360 min对405 min,P=0.01;80 min对100 min,P<0.001)。预后良好组患者血管成功再通率显著高于预后不良组(91.0%对78.5%,P<0.001),术后症状性脑出血发生率显著低于预后不良组(8.5%对28.9%,P<0.001)。多因素logistic回归分析显示,高龄(OR=1.042,95%Cl=1.018~1.066)、伴糖尿病(OR=1.930,95%Cl=1.100~3.385)、入院高NIHSS评分(OR=1.286,95%C1=1.190~1.390)、PTR较长(OR=1.007,95%CI=1.001~1.013)、术后症状性脑出血(OR=3.082,95%Cl=1.419~6.695)均为预后不良的危险因素(P<0.05)。结论 机械取栓治疗急性颅内大血管闭塞有较高的血管再通率和预后良好率。高龄、伴糖尿病、入院高NIHSS评分、PTR较长、术后症状性脑出血均为预后不良的危险因素。

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备注/Memo

备注/Memo:
(收稿日期:2019- 10- 18)
(本文编辑:边 佶)
更新日期/Last Update: 2020-12-16