血管事件健康风险评分对急性脑血管闭塞患者Solitaire AB支架取栓术预后的预测价值  

Role of THRIVE score in predictimg prognosis of acute cerebrovascular occlusion patients after thrombectomy using Solitaire AB stent

作　　者：于海龙 徐俊 李晓波 李军[1] 景坚 王亮珠 杨柳 陈蓓蕾 

机构地区：[1]扬州大学临床医学院江苏省苏北人民医院神经内科,225001

出　　处：《中华老年心脑血管病杂志》2017年第11期1170-1175,共6页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：国家青年科学基金(81400963);国家自然科学基金(81471215;81371377;81271211);江苏省自然科学基金(BK20151592);江苏省青年医学人才项目(QNRC2016327;QNRC2016328)

摘　　要：目的探讨血管事件健康风险(THRIVE)评分对急性脑血管闭塞患者Solitaire AB支架取栓术再通成功率及预后的预测价值。方法选择应用Solitaire AB支架动脉取栓术治疗的急性脑血管闭塞患者61例,根据TICI评分分为再通良好组39例,再通不良组22例。治疗前行美国国立卫生研究院卒中量表(NIHSS)评分及THRIVE评分,3个月后行改良Rankin量表评分,观察患者住院期间主要不良并发症。结果再通良好组3个月预后良好率明显高于再通不良组(43.5%vs 9.1%,P=0.005),入院THRIVE评分和1周后NIHSS评分明显低于再通不良组[(4.64±1.50)分vs(6.32±1.49)分,P=0.000;(12.86±10.94)分vs(21.02±16.35)分,P=0.024]。多因素回归分析显示,THRIVE评分与再通不良、预后不良、死亡及肺部感染相关,与颅内出血不相关。THRIVE评分对患者住院期间发生肺部感染、颅内出血;预后不良及死亡的预测价值均高于NIHSS评分。结论 THRIVE评分与急性脑血管闭塞患者Solitaire AB支架取栓术血管再通成功、住院期间并发症发生及远期预后不良相关。Objective To study the role of THRIVE score in predicting recanalization and prognosis of acute cerebrovascular occlusion patients after thrombectomy using Solitaire AB stent.Methods Sixty acute cerebrovascular occlusion patients after thrombectomy using Solitaire AB stent were divided into good recanalization group（n=39）and poor recanalization group（n=22）.The patients were scored according to the NIHSS and THRIVE before treatment and scored according to the mRS after 3 months of treatment.The major adverse complications of the patients were observed during their hospital stay time.Results The prognosis rate was significantly higher while the THRIVE score and NIHSS score were significantly lower in good recanalization group than in poor recanalization group after 1 week of treatment（43.5% vs 9.1%,P=0.005;4.64±1.50 vs6.32±1.49,P=0.000;12.86±10.94 vs21.02±16.35,P=0.024）.Multivariate logistic regression analysis showed that the THRIVE score was related with the poor recanalization,poor prognosis,mortality and pulmonary infection but not with intracranial hemorrhage.The role of THRIVE score was higher than that of NIHSS score in predicting the poor prognosis,mortality,pulmonary infection and intracranial hemorrhage of patients during their hospital stay time.Conclusion THRIVE score is related with recanalization,complications and poor long-term prognosis in acute cerebrovascular occlusion patients after thrombectomy using Solitaire AB stent.

关 键 词：脑血管障碍 支架 住院病人 手术后并发症 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]