血糖变异度、侧支循环及基底动脉计算机扫描血管造影评分与急性后循环大血管闭塞性脑卒中Solitaire支架机械取栓预后的关系  

Relationship between blood glucose variation, collateral circulation and Batman score and prognosis after mechanical thrombectomy with Solitaire stent in acute posterior vascular occlusive stroke

作　　者：汪宁[1] 温昌明[1] 高军 白方会 刘圆方 孙军[3] Wang Ning;Wen Changming;Gao Jun;Bai Fanghui;Liu Yuanfang;Sun Jun(Nanyang Central Hospital,Neurology Department Cerebrovascular Disease Intervention Ward,Nanyang 473000,China;Nanyang Central Hospital,Pediatric Surgery Department,Nanyang 473000,China;Nanyang Central Hospital,Neurology Department,Nanyang 473000,China)

机构地区：[1]南阳市中心医院神经内科脑血管病介入病区,南阳473000 [2]南阳市中心医院儿外科,南阳473000 [3]南阳市中心医院神经内科,南阳473000

出　　处：《中华医学杂志》2024年第5期365-370,共6页National Medical Journal of China

基　　金：河南省重点研发与推广专项(192102310349)

摘　　要：目的探究血糖变异度(GV)、侧支循环及基底动脉计算机扫描血管造影评分(Batman)与大血管闭塞性急性后循环缺血性卒中(APCI)患者Solitaire支架机械取栓预后的关系。方法回顾性选取2021年3月至2022年7月于南阳市中心医院神经内科行Solitaire支架机械取栓的大血管闭塞性APCI患者共113例,根据预后情况将其分为转归组(46例)及不良组(67例)。术后3个月根据改良Rankin量表评估预后情况,比较两组患者侧支循环情况、GV及Batman评分差异,采用多因素logistic回归模型分析大血管闭塞性APCI患者Solitaire支架机械取栓预后的相关因素。结果113例急性大血管闭塞性APCI患者的年龄为(65.3±8.9)岁,女性39例(34.5%)。与转归组相比,不良组侧支循环比例较低[40例(87.0%)比47例(70.2%)],GV评分较高[(25.19±3.54)比(30.36±4.11)分],Batman评分较低[(7.49±1.52)比(6.65±1.33)分],房颤史构成比较高[16例(23.9%)比14例(8.7%)],入院时美国国立卫生院卒中量表(NIHSS)评分较高[(8.33±0.74)比(7.25±0.92)分],核心梗死体积较大[(32.57±4.87)比(29.54±5.14)ml],入院至血管再通时间较长[(123.52±31.17)比(102.47±29.54)min](均P<0.05)。房颤史、核心梗死体积、入院时NIHSS评分、入院至血管再通时间、GV、侧支循环、Batman评分是大血管闭塞性APCI患者Solitaire支架机械取栓预后的相关因素,OR值(95%CI)分别为1.383(1.124~1.641)、1.166(1.007~1.350)、4.777(1.856~12.297)、3.068(2.379~3.757)、1.477(1.209~1.806)、0.742(0.654~0.831)、0.717(0.214~1.221)(均P<0.05)。结论GV、侧支循环及Batman评分是大血管闭塞性APCI患者Solitaire支架机械取栓预后的相关因素。Objective To explore the relationship between blood glucose variability,collateral circulation and basilar artery computed scan angiography score(Batman)and prognosis of mechanical thrombectomy with Solitaire stent in patients with large vascular occlusive APCI.Methods A retrospective study was conducted on 113 patients with large vessel occlusive APCI who underwent Solitaire stent mechanical thrombectomy in the Department of Neurology of Nanyang Central Hospital from March 2021 to July 2022.According to the prognosis,they were divided into outcome group(46 cases)and adverse group(67 cases).Evaluate the prognosis based on the Modified Rankin Scale three months after the surgery.The differences in collateral circulation,GV and Batman score between the two groups were compared,and the related factors affecting the prognosis of large vessel occlusive APCI patients treated with Solitaire stent mechanical thrombectomy were analyzed by multivariate logistic regression model.Results The age of 113 patients with acute large vessel occlusive APCI was(65.3±8.9)years old.The proportion of female was 34.5%(39 cases).Compared with the outcome group,the adverse group had a lower proportion of collateral circulation[40 cases(87.0%)vs 47 cases(70.2%)],higher GV score[(25.19±3.54)vs(30.36±4.11)points],lower Batman score[(7.49±1.52)vs(6.65±1.33)points],higher proportion of atrial fibrillation history[16 cases(23.9%)vs 4 cases(8.7%)],higher National Institutes of Health Stroke Scale(NIHSS)score at admission[(8.33±0.74)vs(7.25±0.92)points],larger core infarct volume[(32.57±4.87)vs(29.54±5.14)ml],and longer time from admission to vascular recanalization[(123.52±31.17)vs(102.47±29.54)min](all P<0.05).Atrial fibrillation history,core infarct volume,NIHSS score at admission,time from admission to vascular recanalization,glycemic variability,collateral circulation,and Batman score were related factors for the prognosis of large vessel occlusive APCI patients treated with Solitaire stent mechanical thrombectomy,with OR values(9

关 键 词：卒中 急性后循环大血管闭塞性脑卒中 机械取栓 血糖变异度 侧支循环 

分 类 号：R651.12[医药卫生—外科学]