基于多模式CT评估后醒后卒中患者机械取栓治疗的临床疗效分析  

Clinical efficacy analysis of mechanical thrombectomy in patients with wake-up stroke based on multimodal CT imaging

作　　者：周赟[1] 李勇刚[2] 李波[3] 方琪[1] 王辉[1] Zhou Yun;Li Yonggang;Li Bo;Fang Qi;Wang Hui(Department of Neurology,the First Affiliated Hospital of Soochow University,Jiangsu Suzhou 215006,China.;Department of Radiology,the First Affiliated Hospital of Soochow University,Jiangsu Suzhou 215006,China.;Department of Interventional Radiology,the First Affiliated Hospital of Soochow University,Jiangsu Suzhou 215006,China.)

机构地区：[1]苏州大学附属第一医院神经内科,江苏苏州215006 [2]苏州大学附属第一医院放射科,江苏苏州215006 [3]苏州大学附属第一医院介入科,江苏苏州215006

出　　处：《中华介入放射学电子杂志》2021年第1期70-74,共5页Chinese Journal of Interventional Radiology：electronic edition

基　　金：苏州市临床重点病种诊疗技术专项(LCZX201801)。

摘　　要：目的探讨合并大血管闭塞的醒后卒中(WUS)患者的临床特点及经多模式CT评估后机械取栓治疗的疗效分析。方法采用回顾性研究,收集因大血管闭塞所致急性缺血性脑卒中(AIS)并行多模式CT评估后予机械取栓治疗的住院患者189例,按照发病情况将所有入组患者分为WUS组和非醒后卒中(NWUS)组,对比两组患者术前基线资料、取栓术后24 h国立卫生院卒中量表(NIHSS)评分、术后7 d NIHSS评分、住院期间NIHSS评分改善人数和90 d改良Rankin量表(mRS)评分≥3分人数。结果WUS组和NWUS组患者间年龄、性别、高血压病、糖尿病、吸烟史、饮酒史比例及低密度脂蛋白(LDL-C)水平、基线NIHSS评分、卒中血管分布差异均无统计学意义(P>0.05),两组间房颤病史的差异有统计学意义(P<0.05)。WUS组术后24 h NIHSS评分、术后7 d NIHSS评分低于NWUS组,但两组间差异无统计学意义(P>0.05),且住院期间NIHSS评分改善人数和90 d mRS≥3分人数在两组间的分布差异无统计学意义(P>0.05)。结论伴大血管闭塞的醒后卒中的发病与房颤密切相关。经多模式CT评估后接受机械取栓治疗醒后卒中的临床疗效与非醒后卒中患者相似。Objective To investigate the clinical characteristics of wake-up stroke and the efficacy of mechanical thrombectomy in patients with wake-up stroke after multi-modal CT evaluation.Methods A total of 189 inpatients with acute ischemic stroke caused by large artery occlusion and multi-modal CT evaluation treated with mechanical thrombectomy were divided into WUS group(58 cases)and non-WUS group(131 cases).Preoperative baseline data,national Institutes of Health Stroke Scale(NIHSS)score 24 hours after thrombectomy,NIHSS score 7 days after surgery,number of patients with improved NIHSS score during hospitalization,and number of patients with modified Rankin scale(mRS)score≥3 points at 90 days were compared between the two groups.Results There were no statistically significant differences between the two groups in preoperative baseline data except for atrial fibrillation.The NIHSS score 24 hours after thrombectomy,NIHSS score 7 days after thrombectomy and number of patients with mRS score≥3 points at 90 days were lower in the group of WUS,but there were no statistically significant differences between the two groups(P>0.05).Conclusions The onset of wake⁃up stroke is closely related to atrial fibrillation.The clinical efficacy of thrombectomy was similar both in patients with wake-up stroke and non-wake-up stroke based on multi-modal CT imaging.

关 键 词：醒后卒中 机械取栓 多模式CT 房颤 

分 类 号：R743.3[医药卫生—神经病学与精神病学]