前循环大血管闭塞患者预后不良的危险因素分析  

Risk factors for poor prognosis in patients with anterior circulation occlusion

作　　者：韩楠楠 常明则 张格娟 高燕军 葛晗明 马浩钧 史文珍 田晔 Han Nannan;Chang Mingze;Zhang Gejuan(Neurology Department,Xi'an No.3 Hospital,Xi'an 710018)

机构地区：[1]西安市第三医院/西北大学附属医院神经内科,710018

出　　处：《卒中与神经疾病》2020年第4期440-443,共4页Stroke and Nervous Diseases

基　　金：陕西省社会发展科技攻关项目(2016SF-173);国家自然科学基金项目(81660210)。

摘　　要：目的探讨前循环大血管闭塞患者预后不良的危险因素。方法采用回顾性队列研究的方法,分析2017年5月-2018年9月就诊于西北大学附属医院脑病医院,经全脑血管造影术(Digital subtraction angiography, DSA)确诊为前循环大动脉闭塞的患者,采集患者入院时的基线资料及干预措施,随访患者治疗90 d后mRS评分,采用单变量逻辑回归分析筛选预后不良的相关因素,将P<0.01的因素纳入多变量逻辑回归方程中进行分析。结果 1)单因素分析显示患者的预后与以下方面有关:①年龄;②入院NIHSS评分;③ASTIN/SIR评分;④入院CT-ASPECT评分;⑤房颤;⑥高血压病;⑦是否使用rt-PA;⑧是否进行介入治疗;2)多因素分析显示与以下方面有关:NIHSS评分(OR=6.115,95%CI=1.051~35.580,P=0.044),ASTIN/SIR评分(OR=0.214,95%CI=0.061~0.755,P=0.017)。结论入院时高NIHSS评分以及DSA下的低ASTIN/SIR评分是前循环大动脉闭塞患者预后不良的危险因素。Objective To assess risk factors for poor prognosis in patients with anterior circulation occlusion. Methods In this retrospective cohort study, we collected conrfirmed cases of anterior circulation atrery occlusion through the digital substraction angiography from the northwestern university affiliated hospital, from May 2017 to September 2017. Baseline data of the patients on admission and intervention measures were collected, mRS scores of patients were calculated after 90 days of treatment, and the method of univariate logistic regression analysis was used to screen relevant factors of poor prognosis. The factors(P<0.01) included in the multivariate logistic regression equation were analyzed. Results(1) Univariate analysis suggested that the prognosis of patients was related to the following aspects: ①Age, ②NIHSS score at admission,③ASTIN/SIR score,④CT-ASPECT score at admission,⑤Atrial fibrillation, ⑥High blood pressure, ⑦rt-PA, ⑧Interventional therapy.(2) Multivariate analysis suggested that the prognosis of patients aws related to the following aspects: NIHSS grade(OR=6.115, 95% CI=1.051~35.580,P=0.044),ASTIN/SIR grade(OR=0.214, 95% CI=0.061~0.755,P=0.017). Conclusion High admission NIHSS score and low ASTIN/SIR score were independent risk factors for poor prognosis of patients with anterior circulation occlusion.

关 键 词：缺血性脑卒中 侧支代偿 危险因素 前循环大血管闭塞 

分 类 号：R743.3[医药卫生—神经病学与精神病学]