[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