超时间窗后循环缺血性脑梗死TREVO支架取栓再通有效性及对Vaspin认知功能的影响  

Study on the effectiveness of TREVO stent embolization and recanalization of circulatory ischemic cerebral infarction after an extended time window and its effect on Vaspin and cognitive function

作　　者：康梅娟[1] 温昌明[1] 张保朝[1] 孙军[1] 刘义锋[1] 汪宁[1] 张东焕 楚黎君 KANG Meijuan;WEN Changming;ZHANG Baochao;SUN Jun;LIU Yifeng;WANG Ning;ZHANG Donghuan;CHU Lijun(Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]南阳市中心医院,河南南阳473000

出　　处：《中国实用神经疾病杂志》2021年第5期408-413,共6页Chinese Journal of Practical Nervous Diseases

基　　金：河南省科技发展计划项目(编号:192102310349)。

摘　　要：目的分析超时间窗后循环缺血性脑梗死应用TREVO支架取栓再通的有效性及其对丝氨酸蛋白酶抑制剂(Vaspin)、认知功能的影响。方法收集2016-01—2019-12南阳市中心医院超时间窗后循环缺血性脑梗死患者100例,根据随机数字表法分成观察组和对照组各50例。对照组采用人组织型纤溶酶原激活剂(rt-PA)进行静脉溶栓治疗,观察组采用TREVO支架取栓治疗。分析比较患者术前及术后72 h、90 d的NIHSS评分、MoCA评分、血清Vaspin水平,术后90 d mRS评分、并发症发生情况、复发率、病死率。结果2组患者术后72 h、90 d相较术前NIHSS评分均降低,MoCA评分、血清Vaspin水平均升高,且观察组优于对照组。术后90 d观察组的并发症发生情况、复发率优于对照组,mRS评分≤2者占比观察组(58%)显著高于对照组(38%),2组患者术后90 d的病死率无明显差异(P>0.05)。结论TREVO支架取栓再通对超时间窗后循环缺血性脑梗死患者疗效显著,能够明显提高术后患者血清Vaspin水平,有效促进患者神经功能恢复,提高认知功能,改善预后。Objective To analyze the effectiveness of TREVO stent recanalization and its effect on serine protease inhibitor(Vaspin)and cognitive function in circulating ischemic cerebral infarction after an extended time window.Methods A total of 100 patients with circulatory ischemic cerebral infarction after an extended time window in our hospital from January 2016 to December 2019 were collected.According to the random number table method,they were divided into 2 groups,50 cases in the observation group and 50 cases in the control group.The control group was treated with human tissue plasminogen activator(rt-PA)for intravenous thrombolysis,and the observation group was treated with TREVO stent thrombus removal.To analyze and compare patients’NIHSS score,MoCA score,serum Vaspin level,90d mRS score,complications,recurrence rate,and mortality before operation and 72h,90d after operation.Results NIHSS scores of the two groups of patients at 72h and 90d after the operation were lower than that before the operation,and the MoCA scores and serum Vaspin levels were increased,and the observation group was better than the control group.The data showed that the incidence of complications and recurrence rate in the observation group 90 days after surgery was better than that of the control group,and the mRS score≤2 in the observation group(58%)was significantly higher than that in the control group(38%).Patients in the two groups died 90 days after the operation.There is no significant difference in rates.Conclusion TREVO stent recanalization has a significant effect on patients with circulating ischemic cerebral infarction after an extended time window.It can significantly increase the serum Vaspin level in patients after surgery,effectively promote the recovery of patients’neurological function,improve cognitive function,and improve prognosis.

关 键 词：超时间窗 后循环缺血性脑梗死 组织型纤溶酶原激活剂 TREVO支架 血管再通 

分 类 号：R743.33[医药卫生—神经病学与精神病学]