急性脑梗死动脉取栓效果与软脑膜侧支循环的相关性分析  

Correlation between the effect of embolectomy and the collateral circulation of the pia mater in acute cerebral infarction and the analysis of rehabilitation strategies

作　　者：张丹 庄卫生 张伟旗 向静静 别燕娜 Zhang Dan;Zhuang Weisheng;Zhang Weiqi;Xiang Jingjing;Bie Yanna(Department of Neurology,the First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,China)

机构地区：[1]南阳医学高等专科学校第一附属医院神经内科,南阳473000

出　　处：《中国临床实用医学》2023年第5期1-5,共5页China Clinical Practical Medicine

基　　金：2021年河南省医学科技攻关省部共建重点项目(SBGJ20210203)。

摘　　要：目的:探讨动脉取栓术治疗急性脑梗死的效果与软脑膜侧支循环的相关性。方法:本研究为病例对照研究,选取2020年6月至2022年6月南阳医学高等专科学校第一附属医院神经内科收治的121例急性脑梗死患者,男63例,女58例,年龄(60.25±5.43)岁,年龄范围为40~80岁。根据脑部CT血管造影检查结果,侧支循环评分>1分、功能良好的61例患者为良好组,侧支循环评分≤1分、功能不良的60例患者为不良组。所有患者均接受动脉取栓术治疗,比较两组患者的治疗效果,通过Spearman相关性系数分析侧支循环功能与取栓效果的相关性。结果:经动脉取栓术治疗后,良好组患者的脑卒中量表评分[(6.52±1.33)分]、神经元特异性烯醇化酶[(21.44±5.12)μg/ml]、中枢神经特异蛋白水平[(0.33±0.16)μg/L]均低于不良组[(7.23±1.47)分、(24.77±5.33)μg/ml、(0.54±0.29)μg/L],差异有统计学意义( P<0.05)。治疗后,良好组患者的脑血流量[(46.35±5.33)ml/100 g·min^(-1)]、脑血容量[(4.23±0.31)ml/100 g]大于不良组[(43.53±5.28)ml/100 g·min^(-1)、(3.77±0.62)ml/100 g],至最大剩余功能时间[Tmax,(7.73±1.25)s]、低灌注指数[HIR,(0.32±0.11)]小于不良组[(9.62±1.36)s、(0.51±0.23)],差异有统计学意义。良好组患者的取栓效果优于不良组,差异有统计学意义( P<0.05)。术后6个月对患者进行短期随访,不良事件发生率为2.5%(3/121)。Spearman相关性系数显示,侧支循环评分与治疗后的脑血流量、脑血容量正相关,与Tmax、HIR负相关。 结论:急性脑梗死患者的软脑膜侧支循环功能可对动脉取栓术效果产生重要影响,良好的侧支循环功能可增加患者临床获益。ObjectiveExploring the correlation between the effectiveness of arterial thrombectomy in the treatment of acute cerebral infarction and the collateral circulation of the pia mater.MethodsThis study was a case-control study that selected 121 patients with acute cerebral infarction admitted to the Neurology department of the First Affiliated Hospital of Nanyang Medical College from June 2020 to June 2022.There were 63 males and 58 females,aged(60.25±5.43)years old,ranging from 40 to 80 years old.According to the results of brain CT angiography,the 61 patients with collateral circulation score>1 and good function were considered as the good group,while 60 patients with collateral circulation score≤1 and poor function were considered as the poor group.All patients received arterial thrombectomy treatment,and the treatment effects of the two groups of patients were compared.The correlation between collateral circulation function and thrombectomy effect was analyzed using Spearman correlation coefficient.ResultsAfter arterial thrombectomy treatment,the national institute of health stroke scale score[(6.52±1.33)points],neuron specific enolase[(21.44±5.12)μg/ml]and S100-βprotein[(0.33±0.16)μg/L]of patients in the good group were lower than those in the adverse group[(7.23±1.47)points,(24.77±5.33)μg/ml,(0.54±0.29)μg/L],the differences were statistically significant(P<0.05).After treatment,the cerebral blood flow[(46.35±5.33)ml/100 g min-1]and cerebral blood volume[(4.23±0.31)ml/100 g]of the good group patients were greater than those of the bad group[(43.53±5.28)ml/100 g·min-1,(3.77±0.62)ml/100 g],and the maximum remaining functional time(Tmax)was[(7.73±1.25)s],hypoperfusion index(HIR)was[(0.32±0.11)],they were lower than those of the bad group[(9.62±1.36)s,(0.51±0.23)],the differences were statistically significant(P<0.05).The thrombectomy effect of the good group patients was better than that of the bad group,the difference was statistically significant(P<0.05).Short term follow-up was conducted 6

关 键 词：急性脑梗死 动脉取栓术 软脑膜侧支循环 相关性分析 

分 类 号：R743.3[医药卫生—神经病学与精神病学]