颅内动脉高密度征在急性前循环大动脉闭塞取栓治疗中的临床意义  

Clinical implications of hyperdense cerebral artery sign in patients with acute anterior circulation large artery occlusion aftermechanical thrombectomy

作　　者：陈伟[1] 梅照军 曹侃[1] 孙而艺 陆培松[1] 李巧玉[1] 陆新宇[1] CHEN Wei;MEI Zhaojun;CAO Kan;SUN Eryi;LU Peisong;LI Qiaoyu;LU Xinyu(The Affiliated People’s Hospital of Jiangsu University,Zhenjiang 212000,China)

机构地区：[1]江苏大学附属人民医院,江苏镇江212000

出　　处：《中国实用神经疾病杂志》2021年第17期1473-1481,共9页Chinese Journal of Practical Nervous Diseases

基　　金：镇江市社会发展指导性科技计划项目(编号:FZ2020040)。

摘　　要：目的探讨颅内动脉高密度征对急性前循环大动脉闭塞性脑梗死患者机械取栓预后的影响。方法收集2017-01—2020-06江苏大学附属人民医院神经外科收治的93例接收机械取栓治疗的急性前循环大动脉闭塞患者的临床资料,根据术前CT平扫结果分为动脉高密度征组(n=41例)和无动脉高密度征组(n=52例),记录并分析2组患者的基线资料,比较2组术后血管再通率、症状性颅内出血率、90 d良好预后率(MRS≤2分)和病死率。结果术后血管再通率动脉高密度征组87.8%(36/41),低于无动脉高密度征组的88.5%(46/52);症状性颅内出血率动脉高密度征组14.6%(6/41),低于无动脉高密度征组的15.4%(8/52);90 d良好预后率动脉高密度征组51.2%(21/41),低于无动脉高密度征组的55.8%(29/52);术后90 d病死率动脉高密度征组19.5%(8/41),高于无动脉高密度征组的15.4%(8/52),但差异均无统计学意义(P>0.05)。结论急性前循环大动脉闭塞性脑梗死经机械取栓患者的预后与动脉高密度征无明显相关性。Objective To investigate the influences of hyperdense cerebral artery sign(HCAS)in the prognosis of patients with acute anterior circulation large artery occlusion after mechanical thrombectomy.Methods Clinical data of 93 patients with acute anterior circulation large artery occlusive stroke who underwent mechanical thrombectomy in our hospital from January 2017 to June 2020 were collected.The subjects were divided into HCAS group(n=41)and non HCAS group(n=52)according to the preoperative CT scan.The baseline data,the vascular recanalization rate,symptomatic intracranial hemorrhage rate,90-day good prognosis rate and mortality rate were analyzed between the two groups.Results There were no statistical difference in clinical baseline data between two groups.The vascular recanalization rate in HCAS group was 87.8%(36/41)lower than 88.5%(46/52)in the non-HCAS group;the symptomatic intracranial hemorrhage rate in HCAS group was 14.6%(6/41)lower than 15.4%(8/52);the 90-day good prognosis rate in the HCAS group was 51.2%(21/41)lower than 55.8%(29/52);the 90-day mortality rate in the HCAS group was 19.5%(8/41)higher than 15.4%(8/52);but there were no statistical difference between two group(P>0.05).Conclusion There were no significant association between HCAS and the prognosis of patients with acute anterior circulation large artery occlusive stroke after mechanical thrombectomy.

关 键 词：颅内动脉高密度征 大血管闭塞 机械取栓 脑梗死 预后 

分 类 号：R743.33[医药卫生—神经病学与精神病学]