脑白质疏松与急性大脑中动脉闭塞性脑梗死血管内介入治疗预后的关系  

Relationship between leukoaraiosis and prognosis of acute middle cerebral artery occlusive cerebral infarction after intravascular intervention

作　　者：陈鹏 郭俊辉 谷玉平 CHEN Peng;GUO Jun-hui;GU Yu-ping(Department of Neurology,North Guangdong People's Hospital,Shaoguan 512000,China)

机构地区：[1]广东省粵北人民医院神经内科,广东韶关512000

出　　处：《青岛医药卫生》2023年第4期258-261,共4页Qingdao Medical Journal

基　　金：广东省韶关市卫生健康科研项目(Y21082)。

摘　　要：目的探讨脑白质疏松(Leukoaraiosis,LA)与急性大脑中动脉闭塞性脑梗死血管内介入治疗预后的关系。方法选取2021年1月至2021年12月于本院神经内科接受血管内介入治疗的60例急性大脑中动脉闭塞性脑梗死患者,严格依据术前CT平扫影像与van Swieten量表进行LA严重程度分级,其中37例无-轻度LA患者设定为对照组,23例中-重度LA患者设定为观察组,于术后随访90d。对比两组预后,运用多因素Logistic回归分析模型评估LA严重程度与血管内介入治疗术后90d预后的关系。结果观察组术后24h内症状性颅内出血率(43.48%)、术后90d改良Rankin量表(mRS)评分[(2.78±0.63)分]高于对照组[8.11%、(1.69±0.42)分],术后90d预后良好率(60.87%)低于对照组(91.89%),有统计学差异(P<0.05);两组术后90d死亡率相比,无统计学差异(P>0.05);多因素Logistic回归分析显示:LA严重程度是影响急性大脑中动脉闭塞性脑梗死血管内介入治疗后预后不良的危险因素(OR=7.000,95%CI=1.659-29.540,P=0.008)。结论合并LA的急性大脑中动脉闭塞性脑梗死患者,经血管内介入治疗预后不良发生风险较高,且LA程度越重,预后更差,临床需予以重视。Objective To investigate the relationship between leukoaraiosis(LA)and prognosis of acute middle cerebral artery occlusive cerebral infarction after intravascular intervention.Methods Sixty patients with acute middle cerebral artery occlusal cerebral infarction who received intravascular interventional therapy in the Department of Neurology of our hospital from January 2021 to December 2021 were selected and graded for LA severity strictly according to preoperative plain CT images and van Swieten scale.Among them,37 patients with no or mild LA were set as the control group.Twenty-three patients with moderate to severe LA were included in the observation group and were followed up for 90 days after surgery.The prognosis of the two groups was compared,and the relationship between the severity of LA and the prognosis at 90 days after intravascular intervention was evaluated by multivariate Logistic regression analysis.Results The rate of symptomatic intracranial hemorrhage(43.48%)and modified Rankin Scale(mRS)score(2.78±0.63)on postoperative 90d in the observation group were higher than those in the control group(8.11%,1.69±0.42).The good prognosis rate at 90 days after operation(60.87%)was lower than that of control group(91.89%),with statistical difference(P<0.05).There was no significant difference in postoperative mortality at 90 days between the two groups(P>0.05).Multivariate Logistic regression analysis showed that the severity of LA was a risk factor for poor prognosis after intravascular intervention in acute middle cerebral artery occlusive cerebral infarction(OR=7.000,95%CI=1.659-29.540,P=0.008).Conclusion In patients with acute middle cerebral artery occlusive cerebral infarction complicated with LA,the risk of poor prognosis is higher after intraventricular intervention,and the worse the degree of LA,the worse the prognosis,which should be paid attention to clinically.

关 键 词：脑白质疏松 急性大脑中动脉闭塞性脑梗死 血管内介入治疗 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]