ASPECTS联合血清HO-1,VEGF水平与急性后循环供血区缺血性脑梗死患者血管再通术后短期不良预后的关系  

The relationship between ASPECTS combined with serum HO-1,VEGF levels and short-term prognosis after recanalization in patients with ischemic cerebral infarction in the acute posterior circulation supply area

作　　者：汪宁[1] 孙军[1] 刘义锋[1] 高军 刘圆 方裴双 杨银雪 张在行 张冬焕 温昌明[1] Wang Ning;Sun Jun;Liu Yifeng(Cerebrovascular Intervention Ward,Department of Neurology,Nanyang Central Hospital,Nanyang Henan 473000)

机构地区：[1]河南省南阳市中心医院神经内科脑血管介入病区,473000

出　　处：《卒中与神经疾病》2023年第3期254-258,264,共6页Stroke and Nervous Diseases

基　　金：河南省医学科技攻关项目(编号为2017T02036)。

摘　　要：目的探究急性后循环供血区缺血性脑梗死患者血管再通术后24 h内Alberta卒中操作早期CT评分(Alberta stroke program early CT score,ASPECTS)联合血清血红素氧合酶-1(Heme oxygenase-1,HO-1)、血管内皮生长因子(Vascular endothelial growth factor,VEGF)水平对患者短期不良预后的预测价值。方法选取医院2019年1月-2020年1月收治的62例急性后循环供血区缺血性脑梗死患者,均行血管再通术;术后随访3个月,根据改良Rankin量表评分(Modified Rankin scale,mRS)进行神经功能评定,分为预后良好组、预后不良组,采用单因素分析比较2组术后24h内ASPECTS评分、血清HO-1,VEGF水平等可能影响患者短期不良预后的因素;采用Logistic回归分析急性后循环供血区缺血性脑梗死患者血管再通术后影响患者短期不良预后的危险因素,并绘制受试者工作特征(Receiver operating characteristic,ROC)曲线评估术后ASPECTS评分联合血清HO-1,VEGF水平对患者短期不良预后的预测价值。结果根据随访3个月后mRS评分判定,62例患者中40例归为预后良好组,22例归为预后不良组。单因素分析中2组患者性别、年龄、体质量指数、是否吸烟、酗酒,高脂血症、糖尿病、冠心病、既往脑卒中、高血压病等既往病史、治疗前血压、术后24 h内血压、发病至入院时间、术后24 h内实验室检查指标(白细胞计数、血小板、血糖、血尿素、血肌酐、胱抑素C)水平均无明显差异(P>0.05);预后良好组既往病史中心房颤动占比(12.50%)低于预后不良组(45.45%)(P<0.05),术后24 h内NIHSS评分低于预后不良组(P<0.05),术后24 h内ASPECTS评分高于预后不良组(P<0.05)。术后24 h内实验室检查指标中预后良好组血清HO-1水平高于预后不良组,VEGF水平低于预后不良组(P<0.05)。经Logistic回归分析显示,心房颤动史、术后24 h内NIHSS评分、术后24 h内ASPECTS评分、血清HO-1,VEGF水平是影响急性后循环供血区缺血性脑�ObjectiveTo investigate the predictive value of the Alberta Stroke Program Early CT Score(ASPECTS)combined with serum heme oxygenase-1(HO-1)and vascular endothelial growth factor(VEGF)levels in patients with ischemic cerebral infarction in the acute posterior circulation supply area 24 h after revascularization.Methods Sixty-two patients with ischemic cerebral infarction in the acute posterior circulation supply area admitted to the hospital from January 2019 to January 2020 were selected and underwent revascularization.Postoperative follow-up was performed for 3 months.Neurological function was assessed according to the modified Rankin scale(mRS),and patients were divided into good prognosis group and poor prognosis group using univariate analysis.The factors that may affect the short-term prognosis of patients,such as ASPECTS score,serum HO-1 and VEGF level within 24 h after surgery,were compared between the two groups.Logistic regression was used to analyze the risk factors affecting the short-term poor prognosis of patients with ischemic cerebral infarction in the acute posterior circulation supply area after revascularization,and receiver operating characteristic(ROC)curves were plotted to assess the prognosis of the patients.ROC curves were used to assess the predictive value of the postoperative ASPECTS score combined with serum HO-1 and VEGF levels on the short-term prognosis of patients.Results According to the MRS score,40 of the 62 patients were classified as the good prognosis group,and 22 patients were classified as the poor prognosis group.In the univariate analysis,previous medical histories such as sex,age,body mass index,smoking,alcoholism,hyperlipidemia,diabetes,coronary heart disease,previous stroke,hypertension,blood pressure before treatment,blood pressure 24 hours after treatment,and onset to the time of admission were analyzed.There were no significant differences in laboratory tests(white blood cell count,platelet count,blood sugar,blood urea,blood creatinine,cystatin C)(P>0.05).The propor

关 键 词：后循环供血区 急性缺血性脑梗死 血管再通术 短期预后 Alberta卒中操作早期CT评分 血红素氧合酶-1 血管内皮生长因子 

分 类 号：R743.3[医药卫生—神经病学与精神病学]