[1]陆小小,许 磊,苏浩波,等.急性缺血性脑卒中桥接治疗临床效果及预后影响因素探讨[J].介入放射学杂志,2021,30(06):595-599.
　LU Xiaoxiao,XU Lei,SU Haobo,et al.The curative effect of bridging therapy for acute ischemic stroke and the discussion on the prognostic factors[J].journal interventional radiology,2021,30(06):595-599.
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急性缺血性脑卒中桥接治疗临床效果及预后影响因素探讨()

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

卷:
30
期数:
2021年06
页码:
595-599
栏目:
临床研究
出版日期:
2021-06-26

文章信息/Info

Title:
The curative effect of bridging therapy for acute ischemic stroke and the discussion on the prognostic factors
作者:
陆小小;  许 磊;  苏浩波;  赵伯翔;  顾建平;  缪正飞
Author(s):
LU Xiaoxiao;  XU Lei;  SU Haobo;  ZHAO Boxiang;  GU Jianping;  MIAO Zhenfei.
Department of Oncology， Lianyungang Municipal Second People’s Hospital， Lianyungang， Jiangsu Province 222023， China
关键词:
【关键词】 急性缺血性脑卒中;  血管内取栓术;  静脉溶栓;  预后
文献标志码:
A
摘要:
【摘要】 目的 探讨急性大动脉缺血性脑卒中静脉溶栓（IVT）后血管内取栓术（EVT）治疗（桥接治疗）的临床效果及预后影响因素。方法 回顾性分析2017年1月至2019年9月南京市第一医院收治的135例急性缺血性脑卒中患者临床资料。根据治疗方法分为桥接治疗组（n=64）和单纯EVT治疗组（n=71）。根据改良溶栓治疗脑梗死（mTICI）血流分级比较两组患者血管再通率，改良Rankin量表（mRS）评分比较预后。多因素logistic回归法分析桥接治疗预后影响因素。结果 桥接治疗组与单纯EVT治疗组相比，侧支循环更丰富[美国介入和治疗神经放射学会（ASITN）分级3.13±0.54对2.27±1.22，t=4.463，P=0.035]；治疗后血管再通成功率（mTICI血流分级2b～3级）稍高（67.2%对52.1%）、出血转化比例稍高（42.2%对40.9%），但差异均无统计学意义（P＞0.05）。桥接治疗组出院mRS评分0～2分比例（54.69%对36.62%，χ2=4.436，P=0.039）、3个月mRS评分0～2分比例（64.06%对43.66%，χ2=5.628，P=0.025）显著高于单纯EVT治疗组。多因素logistic回归分析显示，入院DWI梗死体积（OR=0.723，95%CI=0.254～1.698，P=0.032）、侧支循环（OR=6.062，95%CI=1.563～26.971，P=0.012）、血管再通程度（OR=0.091，95%CI=0.024～0.489，P=0.035）和EVT术前IVT（OR=9.514，95%CI=1.832～35.245，P=0.008）是急性缺血性脑卒中患者预后的独立影响因素。结论 EVT术前IVT可改善急性缺血性脑卒中患者预后。综合评估入院DWI梗死体积、侧支循环、血管再通程度及是否行IVT有助于预测EVT治疗预后，指导临床康复治疗。

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备注/Memo

备注/Memo:
（收稿日期：2020- 03- 25）
（本文编辑：边 佶）
更新日期/Last Update: 2021-06-25