机械取栓治疗急性前循环大血管闭塞性脑梗死患者预后的影响因素  

Influencing factors for predicting prognosis after mechanical thrombectomy in patients with acute ischemic stroke due to large vessel occlusion

作　　者：吴建明 马斌武[1] 吴艳蓉 杨平[1] 谭波飞 邵娜 WU Jianming;MA Binwu;WU Yanrong;YANG Ping;TAN Bofei;SHAO Na(General Hospital of Ningxia Medical University,Yinchuan 750000,China)

机构地区：[1]宁夏医科大学总医院,宁夏银川750000

出　　处：《中国实用神经疾病杂志》2022年第12期1453-1457,共5页Chinese Journal of Practical Nervous Diseases

摘　　要：目的分析机械取栓治疗急性前循环大血管闭塞性脑梗死患者预后的影响因素。方法回顾性纳入2019-07—2022-02宁夏医科大学总医院治疗的急性前循环大血管闭塞性脑梗死患者102例,均采用机械取栓治疗。根据患者90 d后改良Rankin量表评分分为预后良好组和预后不良组,对2组患者的临床资料进行比较,通过Logistic回归分析寻找影响预后的因素。结果102例患者中预后良好53例,预后不良49例,预后良好率51.9%。多因素Logistic回归分析显示侧支循环差(OR=0.784,95%CI 0.653~0.916,P<0.01)、术后并发脑出血(OR=0.804,95%CI 0.678~0.931,P<0.01)为急性前循环大血管闭塞性脑梗死患者机械取栓术预后不良的独立危险因素。ROC曲线显示,侧支循环差曲线下面积AUC=0.784,灵敏度68.0%,特异度88.9%;术后并发脑出血曲线下面积AUC=0.804,灵敏度72.0%,特异度88.9%。结论侧支循环差、术后并发脑出血是急性前循环大血管闭塞性脑梗死患者机械取栓预后不良的独立危险因素,尽早识别并予以临床干预非常重要。Objective To explore the influencing factors for predicting prognosis after mechanical thrombectomy in patients with acute ischemic stroke due to large vessel occlusion.Methods We retrospectively reviewed102 consecutive patients data with acute ischemic stroke due to large vessel occlusion who underwent mechanical thrombectomy from July 2019 to February 2022 in General Hospital of Ningxia Medical University.All patients were divided into the good prognosis group and the poor prognosis group according to modified Rankin scale(mRS)at 3 months for follow-up.The clinical date were collected and compared,multivariate Logistic regression analysis were used to screen the influencing factors for prognosis.Results Good prognosis was observed in 53(51.9%).Multivariate Logistic regression analysis showed that patients with poor collaterals(OR=0.784,95%CI0.653-0.916,P<0.01)and intracranial hemorrhage(OR=0.804,95%CI 0.678-0.931,P<0.01)were risk factors for prognosis of mechanical thrombectomy in patients with acute ischemic stroke due to large vessel occlusion.Receiver operating characteristic curve showed AUC in patients with poor collaterals was 0.784,sensitivity was68.0%,specificity was 88.9%;AUC of intracranial hemorrhage was 0.804,sensitivity was72.0%,specificity was88.9%.Conclusion patients with poor collaterals and intracranial hemorrhage was revealed as a risk factors for prognosis.Early identification and prevention were important.

关 键 词：急性缺血性卒中 机械取栓 危险因素 临床预后 侧支循环 脑出血 

分 类 号：R743.33[医药卫生—神经病学与精神病学]