左心室射血分数对急性心源性前循环大血管闭塞性脑卒中血管内治疗预后的影响  

The effect of left ventricular ejection fraction on the prognosis of patients with acute cardiogenic anterior circulation large vessel occlusive stroke after receiving endovascular treatment

作　　者：左鹏 倪小宇[1] 徐长松[1] 吴嶛 倪贵华[1] ZUO Peng;NI Xiaoyu;XU Changsong;WU Liao;NI Guihua(Department of Neurology,Affiliated Huai’an Municipal First People’s Hospital of Nanjing Medical University,Huai'an,Jiangsu Province 223300,China)

机构地区：[1]南京医科大学附属淮安第一医院神经内科,江苏淮安223300

出　　处：《介入放射学杂志》2022年第12期1189-1193,共5页Journal of Interventional Radiology

摘　　要：目的探讨左心室射血分数(LVEF)对急性心源性前循环大血管闭塞性脑卒中患者血管内治疗预后的影响。方法回顾性分析自2019年1月至2021年1月南京医科大学附属淮安第一医院采用血管内介入术治疗的78例急性心源性前循环大血管闭塞性脑卒中患者超声心动图数据。定义LVEF≥50%为正常值,<50%为下降值。术后3个月采用改良Rankin量表(mRS)评分评估患者预后,0~2分为预后良好,3~6分为预后不良。采用多因素logistic回归分析判断预后影响因素。结果术后预后良好44例(56.4%),预后不良34例(43.6%)。预后良好组与预后不良组相比,LVEF下降(9.1%比26.5%,P=0.041)、左心室舒张功能减低(29.5%比52.9%,P=0.036)差异均有统计学意义。多因素logistic回归分析结果显示,LVEF下降(OR=0.195,P=0.032)、入院时美国国立卫生研究院卒中量表(NIHSS)评分(OR=0.889,P=0.030)、伴糖尿病(OR=0.217,P=0.014)和颈内动脉末端闭塞(OR=0.278,P=0.028)是急性心源性前循环大血管闭塞性脑卒中患者血管内治疗术后良好预后的独立危险因素。结论急性心源性前循环大血管闭塞性脑卒中患者血管内治疗后LVEF(<50%)下降,临床预后较差。Objective To investigate the effect of left ventricular ejection fraction(LVEF)on the prognosis of patients with acute cardiogenic anterior circulation large vessel occlusive stroke after receiving endovascular treatment.Methods The echocardiographic data of 78 patients with acute cardiogenic anterior circulation large vessel occlusive stroke,who were admitted to the Affiliated Huai’an Municipal First People’s Hospital of Nanjing Medical University of China to receive endovascular treatment between January 2019 and January2021,were retrospectively analyzed.The LVEF≥50%was defined as a normal value,and the LVEF<50%was defined as a dropping value.Three months after surgery,the modified Rankin Scale(mRS)score was used to assess patient prognosis,0-2 points indicated a good prognosis,and 3-6 points indicated a poor prognosis.Multivariate logistic regression analysis was used to determine the prognostic factors.Results Good prognosis was obtained in 44 patients(56.4%),and poor prognosis was seen in 34 patients(43.6%).The incidences of decreased LVEF and left ventricular diastolic dysfunction in the good prognosis group were 9.1%and 29.5%respectively,which in the poor prognosis group were 26.5%and 52.9%respectively,the differences between the two groups were statistically significant(P=0.041 and P=0.036 respectively).Multivariate logistic regression analysis showed that decreased LVEF(OR=0.195,P=0.032),National Institute of Health Stroke Scale(NIHSS)score at admission(OR=0.889,P=0.030),coexisting diabetes mellitus(OR=0.217,P=0.014),and internal carotid artery terminal occlusion(OR=0.278,P=0.028)were the independent risk factors for good prognosis in patients with acute cardiogenic anterior circulation large vessel occlusive stroke after receiving endovascular treatment.Conclusion In patients with acute cardiogenic anterior circulation large vessel occlusive stroke after receiving endovascular treatment,a decreased LVEF(<50%)suggests a poor clinical prognosis.(J Intervent Radiol,2022,31:1189-1193)

关 键 词：左心室射血分数 心源性脑卒中 血管内治疗 预后因素 

分 类 号：R541[医药卫生—心血管疾病]