脑血管侧支循环建立程度预测大脑中动脉狭窄患者支架置入术后转归的价值  

Value of cerebrovascular collateral circulation establishment for predicting outcome in MCAS patients after Neuroform EZ stent implantation

作　　者：张继伟[1] 李亮[1] 齐宝柱 孙文浩[1] 于淼[1] 李东 田宇 王广[1] Zhang Jiwei;Li Liang;Qi Baozhu;Sun Wenhao;Yu Miao;Li Dong;Tian Yu;Wang Guang(Department of Neurosurgery,Affiliated Hospital of Chengde Medical College,Chengde 067000,Hebei Province,China)

机构地区：[1]承德医学院附属医院神经外科,067000

出　　处：《中华老年心脑血管病杂志》2022年第2期124-127,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：河北省卫生健康委员会医学科学研究课题(20200381)。

摘　　要：目的探讨脑血管侧支循环建立程度预测大脑中动脉狭窄患者Neuroform EZ支架置入术后转归的价值。方法纳入行Neuroform EZ支架置入术的大脑中动脉狭窄患者189例,根据侧支代偿程度分为初级代偿组49例、次级代偿组40例和三级代偿组24例及未开放组76例。采用美国国立卫生研究院卒中量表(NIHSS)评估神经功能,改良的Rankin量表(m RS)评估生活质量,随访12个月,采用logistic回归分析术后转归的独立影响因素。结果与未开放组比较,其他3组术前、术后1、12个月NIHSS评分以及术后1、12个月m RS评分明显降低(P<0.05)。logistic回归分析显示,年龄>75岁(OR=2.030,95%CI:1.069~3.853)、脑卒中史(OR=1.842,95%CI:1.221~2.780)、糖尿病(OR=1.505,95%CI:1.267~1.789)及侧支循环建立程度(OR=2.052,95%CI:1.136~3.710)是影响预后不良的独立危险因素(P<0.05,P<0.01)。结论脑血管侧支循环建立程度与术后NIHSS评分和mRS评分相关,且其是大脑中动脉狭窄患者Neuroform EZ支架置入术后转归的独立危险因素。Objective To study the value of cerebrovascular collateral circulation establishment for implantation.Methods One stent predicting the outcome in MCAS patients after Neuroform EZ hundred and eighty-nine MCAS patients who underwent Neuroform EZ stent implantation were group(n=49),secondary group(n=40),tertia-divided into primary compensation group(n=24),and compensation group(n=76).Their ry compensation tion non compensation NIHSS neurological funcwas evaluated according to the score.The quality of life was assessed according to the post-months,during12m RS score.The patients were followed up for which the risk factors for analysis.Re-operative cerebrovascular collateral circulation were analyzed by logistic regression was sults The NIHSS score was significantly higher while the m RS score non significantly lower in primary,secondary and tertiary compensation groups than in analysis compensation group at months1operation(P<0.05).Logistic after years,history>75and12regression showed that age DM,and and of cerebral stroke risk cerebrovascular collateral circulation establishment were indepatients(OR=2.030,95%CI:1.069-3.853;pendent factors for the poor outcome in MCAS OR=1.842,95%CI:1.221-2.780;OR=1.505,95%CI:1.267-1.789;OR=2.052,95%CI:1.136-3.710;P<0.05,P<0.01).Conclusion Cerebrovascular collateral circulation establishscore,and m RS ment is related with the postoperative NIHSS score and is an independent risk factor for the poor outcome in MCAS patients after Neuroform EZ stent implantation.

关 键 词：脑血管障碍 侧支循环 大脑中动脉 支架 

分 类 号：R743.3[医药卫生—神经病学与精神病学]