侧枝循环对急性缺血性脑卒中静脉溶栓的预后评估  

Collateral circulation in assessing prognosis of patients with acute cerebral infarction after intravenous thrombolysis

作　　者：许孝南 戚玉龙[1] 李谆晶[1] 陈旭辉[1] 童晓欣[1] 吴军[1] 胡俊[1] 

机构地区：[1]北京大学深圳医院神经内科,深圳518036

出　　处：《卒中与神经疾病》2017年第6期495-498,共4页Stroke and Nervous Diseases

基　　金：深圳市科创委科研基金(编号为JYC2014031709172271)

摘　　要：目的探讨Alberta卒中早期CT评分(ASPECTS)评估侧枝循环对急性大脑中动脉供血压梗死静脉溶栓的疗效以及预后。方法选择北京大学深圳医院神经内科自2015年9月~2016年9月接受静脉溶栓治疗的急性大脑中动脉供血压梗死患者39例,依据溶栓前ASPECTS评分分为侧枝良好组及侧枝不良组,比较2组间临床资料及溶栓后90 d的预后差异;再以预后是否良好为因变量进行Logistic回归分析。结果侧枝良好组美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分更低、ONT(onset to needle time)更短,则预后更好。Logistec回归分析显示ASPECTS评分是评估预后是否良好的独立预测因子(OR:39.395,95%CI=1.336~1161.514,P=0.033)。结论 ASPECTS可准确评估侧枝循环,对静脉溶栓有明确的指导治疗作用。Objective To evaluate the role of Alberta stroke program early CT scale（ ASPECTS） in predicting collateral circulation of patients with acute middle cerebral artery infarction,and functional outcomes after intravenous thrombolysis. Methods 39 patients with acute middle cerebral infarction after intravenous thrombolysis in the department of neurology in Peiking University Shenzhen Hospital were chosen from September 2015 to September2016. According to ASPECTS,the favorable and unfavorable collateral groups were defined,The clinical data,scores of ASPECTS and Logistic variables were analyzed. Results As compared with patients in the U group,the F group had significantly lower NIHSS scores,shorter ONT and higher functional outcomes（ P〈0. 05）. Logistic regression analysis showed that ASPECTS scores（ OR： 39. 395,95% CI = 1. 336 ~ 1161. 514,P = 0. 033） was the independent predictors 90 days after thrombolysis. Conclusion ASPECTS could assess collateral circulation accurately,which was of great value in directing intravenous thrombolysis.

关 键 词：侧枝循环 脑梗死 Alberta卒中早期CT评分 静脉溶栓 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]