DWI-ASPECTS评分与前循环急性缺血性卒中患者机械取栓术后转归的相关性分析  

Correlation analysis of DWI-ASPECT score and Outcomes of anterior circulation acute ischemic stroke treated by mechanical thrombectomy

作　　者：江涛 闫莉莉 陈名宇 沈雁婕 任振华 JIANG Tao;YAN Lili;CHEN Mingyu(Department of Neurosurgery,the Fourth Affiliated Hospital of Anhui Medical University,Hefei 230601,China)

机构地区：[1]安徽医科大学第四附属医院神经外科,安徽合肥230601 [2]安徽医科大学基础医学院解剖学教研室,安徽合肥230032 [3]安徽医科大学基础医学院神经生物学教研室,安徽合肥230032

出　　处：《中风与神经疾病杂志》2020年第9期834-839,共6页Journal of Apoplexy and Nervous Diseases

基　　金：安徽高校自然科学研究项目(KJ2019A0259和KJ2019A0940);安徽省转化医学院科研基金项目(2017zhyx17)。

摘　　要：目的探讨DWI-ASPECTS评分对前循环急性缺血性卒中患者Solitaire AB支架取栓术的预后价值。方法回顾性分析我科2014年1月~2018年3月就治的17例前循环急性缺血性卒中患者的临床资料。收集患者一般临床资料,以及DWI-ASPECTS评分、入院NIHSS评分、出院NIHSS评分、出院mRS评分、出院GOS评分、有无症状性颅内出血、有无放射冠等资料。3 m后,mRS评分、FAQ评分和GOS评分。根据DWI-ASPECTS评分,分成≥7分组,<7分组;mRS评分≤2分定义为预后良好,mRS评分>2分为预后不良。研究DWI-ASPECT评分及其他可能影响临床预后的因素。结果共17例患者行机械取栓术,术前DWI-ASPECTS评分≥7分9例,评分<7分8例。评分≥7分9例患者中,术后mRS评分≤2分8例,预后良好,仅1例患者评分为>2分;而评分<7分8例,仅1例患者mRS评分≤2分;两组之间差别明显(P<0.001)。另一方面,良好预后组9例患者,入院时DWI-ASPECTS评分8例超过7分,仅1例患者评分为6分;而不良预后组8例患者中,仅有一例患者评分为7分,两组之间差别明显(P<0.001)。结论DWI-ASPECTS评分可以作为前循环急性缺血性卒中患者术前评估的指标。评分≥7分的患者Solitaire AB支架取栓术预后良好。Objective To evaluate the value of diffusion-weighted imaging-Alberta Stroke Program Early Computed Tomography(DWI-ASPECT)score in clinical outcomes in patients with acute anterior circulation occlusion treated by thrombectomy using solitaire AB stent.Methods Between January 2014 to March 2018,a total of 17 patients with acute anterior circulation occlusion were treated by thrombectomy using Solitaire AB stent.All the patients accepted assessment of DWI-ASPECT scores and NIHSS scores before undergoing endovascular treatment.General clinical data of patients,as well as DWI-ASPECTS scores,discharged NIHSS scores,discharged The modified Rankin Scale(mRS)scores,discharged Glasgow Outcome Scale(GOS)scores,intracranial hemorrhage,and presence or absence of radiation crown of each patient,were retrospectively analyzed.3 months after thrombectomy,mRS scores,GOS scores and the functional activities questionary(FAQ)score of each patient were recorded.According to the DWI-ASPECTS score,the patients were divided into two group,one is the score≥7 group,and the other is<7 group.The mRS score≤2 was defined as a good prognosis,and>2 was as a poor prognosis.The correlation between with DWI-ASPECT scores,mRS scores and other factors were also analyzed.Results Mechanical thrombectomy with Solitaire AB stent was performed in 19 patients.DWI-ASPECTS scores≥7 were in 9 cases,and the score<7 points was in 8 cases.A good prognosis(mRS scores≤2)was observed in 8 patients in≥7 group,and a poor prognosis(mRS score≤2)was observed in only 1 patients in<7 group.There was significantly difference in clinical outcomes between the two groups(P<0.001).Moreover,a good prognosis was observed in 9 patients,and there are 8 cases of DWI-ASPECTS score over 7 points among of them.A poor prognosis was observed in 8 patients,and there are only one case over 7 points.Conclusion DWI-ASPECTS score can be used as an indicator for preoperative assessment of patients with acute anterior circulation occlusion.Patients with DWI-ASPECTS score of≥7 ha

关 键 词：急性缺血性卒中 DWI-SPECTS评分 机械取栓术 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]