急性基底动脉闭塞患者血管内治疗后转归的预测因素  

Predictors of outcome after endovascular therapy in patients with acute basilar artery occlusion

作　　者：余书康 靳瑜[1] Yu Shukang;Jin Yu(Department of Neurology,Bozhou People's Hospital,Bozhou 236800,China)

机构地区：[1]亳州市人民医院神经内科,236800

出　　处：《国际脑血管病杂志》2023年第1期6-11,共6页International Journal of Cerebrovascular Diseases

摘　　要：目的探讨急性基底动脉闭塞(acute basilar artery occlusion,ABAO)患者血管内治疗(endovascular therapy,EVT)后转归的预测因素。方法前瞻性纳入2019年5月至2022年9月在亳州市人民医院接受EVT的ABAO患者。收集人口统计学、临床资料、围操作期相关参数以及随访资料。在术后90 d进行转归评价,改良Rankin量表评分≤3分定义为转归良好,>3分定义为转归不良。应用多变量logistic回归分析确定EVT后转归良好的独立影响因素。结果共纳入42例ABAO患者,21例(50.0%)转归良好,21例(50.0%)转归不良组。两组患者在入院时美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分、后循环阿尔伯塔卒中项目早期CT评分(posterior circulation Alberta Stroke Program Early CT Score,pc-ASPECTS)、发病至血管再通时间以及血管成功再通、使用补救治疗措施和发生并发症的患者构成比方面差异存在统计学意义(P均<0.05)。多变量logistic回归分析显示,在校正其他危险因素后,低NIHSS评分[优势比(odds ratio,OR)0.756,95%置信区间(confidence interval,CI)0.615~0.903;P=0.008]、较少使用补救治疗措施(OR 0.170,95%CI 0.033~0.884;P=0.035)以及高pc-ASPECTS(OR 4.274,95%CI 1.418~12.882;P=0.010)是转归良好的独立预测因素。结论半数ABAO患者EVT后转归良好,入院时低NIHSS评分、高pc-ASPECTS以及较少使用补救措施是ABAO患者转归良好的独立预测因素。Objective To investigate the predictors of outcome after endovascular therapy in patients with acute basilar artery occlusion(ABAO).Methods Patients with ABAO received EVT in Bozhou People’s Hospital from May 2019 to September 2022 were included prospectively.The demographic data,clinical data,relevant parameters of periprocedural period and follow-up data were collected.The outcome evaluation was performed at 90 d after procedure.The modified Rankin Scale score≤3 was defined as good outcome,and>3 was defined as poor outcome.Multivariate logistic regression analysis was used to determine the independent influencing factors of good outcome after EVT.Results A total of 42 patients with ABAO were included,21(50%)had a good outcome and 21 had a poor outcome.There were significant differences in the National Institutes of Health Stroke Scale(NIHSS),posterior circulation Alberta Stroke Program Early CT Score(pc-ASPECTS),the time from onset to recanalization,the proportion of patients with successful recanalization,use of remedial treatment,and complications were statistically significant in both groups(all P<0.05).Multivariate logistic regression analysis showed that after adjusting for other risk factors,the low NIHSS score(odds ratio[OR]0.756,95%confidence interval[CI]0.615-0.903;P=0.008),less use of remedial treatment measures(OR 0.170,95%CI 0.033-0.884;P=0.035)and high pc-ASPECTS(OR 4.274,95%CI 1.418-12.882;P=0.010)were the independent predictors of good outcomes.Conclusions Half of the patients with ABAO have a good outcome after EVT.Low NIHSS score,high pc-ASPECTS at admission and less use of remedial measures are the independent predictors of good outcomes in patients with ABAO.

关 键 词：缺血性卒中 椎底动脉供血不足 血管内手术 血栓切除术 治疗结果 

分 类 号：R651.12[医药卫生—外科学]