颅内大动脉闭塞脑梗死患者机械取栓后靶血管残余狭窄状况及影响因素分析  

Analysis of residual stenosis of target vessels in patients with intracranial large artery occlusion and cerebral infarction after mechanical thrombectomy and the influencing factors

作　　者：陈娜 杨海华 周晓梅 贾白雪 CHEN Na;YANG Haihua;ZHOU Xiaomei(Department of Neurology,Daxing Teaching Hospital,Capital Medical University,Beijing 102600,China)

机构地区：[1]首都医科大学大兴教学医院神经内科,北京市102600 [2]首都医科大学附属北京天坛医院介入神经病学科

出　　处：《河北医药》2024年第2期293-296,共4页Hebei Medical Journal

基　　金：首都医科大学大兴教学医院院级课题立项项目(编号:4202213426)。

摘　　要：目的研究颅内大动脉闭塞脑梗死患者机械取栓后靶血管残余狭窄状况并分析其影响因素。方法回顾性分析医院2020至2022年行机械取栓术的102例颅内大动脉闭塞脑梗死患者的临床资料。根据患者取栓后即刻靶血管是否发生残余狭窄,将其分为残余狭窄组(n=49)和无残余狭窄组(n=53)。收集患者基线资料,采用二元Logistic回归分析影响颅内大动脉闭塞脑梗死患者机械取栓后靶血管残余狭窄状况的相关因素。结果残余狭窄组患者中有高血压史、糖尿病史、高脂血症史的占比多于无残余狭窄组,术前同型半胱氨酸(Hcy)、术前纤维蛋白原(FIB)高于无残余狭窄组,术前凝血酶原时间(PT)短于无残余狭窄组,差异有统计学意义(P<0.05)。经二元Logistic回归分析显示,高血压史、糖尿病史、高脂血症史、Hcy、FIB是颅内大动脉闭塞脑梗死患者机械取栓后靶血管残余狭窄的危险因素(OR>1,P<0.05),PT是颅内大动脉闭塞脑梗死患者机械取栓后靶血管残余狭窄的保护因素(OR<1,P<0.05)。结论高血压史、糖尿病史、高脂血症史、术前Hcy、术前FIB及PT是颅内大动脉闭塞脑梗死患者机械取栓后靶血管残余狭窄的影响因素。Objective To investigate the residual stenosis of target blood vessels in patients with cerebral infarction caused by intracranial large artery occlusion after mechanical thrombectomy and its influencing factors.Methods Clinical data of 102 patients with intracranial large artery occlusion and cerebral infarction who underwent mechanical thrombectomy in the hospital from January 2020 to December 2022 were retrospectively analyzed.According to the presence and absence of residual stenosis in the target vessel immediately after thrombectomy,patients were divided into residual stenosis group(n=49)and non-residual stenosis group(n=53).The baseline data of patients were collected,and the relevant factors affecting the residual stenosis of target vessels after mechanical thrombectomy in patients with intracranial large artery occlusion and cerebral infarction were analyzed by the binary Logistic regression.Results Compared with those of non-residual stenosis group,patients in the residual stenosis group presented a significantly higher proportion of history of hypertension,diabetes and hyperlipidemia,higher preoperative levels of homocysteine(Hcy)and fibrinogen(FIB)and shorter preoperative prothrombin time(PT)(P<0.05).The binary Logistic regression analysis showed that history of hypertension,history of diabetes,history of hyperlipidemia,Hcy,FIB were risk factors for residual stenosis of target vessels after mechanical thrombectomy in patients with cerebral infarction due to intracranial large artery occlusion(OR>1,P<0.05),and PT was the protective factor (OR<1,P<0.05).Conclusion History of hypertension,diabetes and hyperlipidemia,preoperative Hcy,preoperative FIB and PT are the influencing factors for residual stenosis of target vessels after mechanical thrombectomy in patients with cerebral infarction caused by intracranial large artery occlusion.

关 键 词：颅内大动脉闭塞 脑梗死 机械取栓 残余狭窄 影响因素 

分 类 号：R561.12[医药卫生—呼吸系统]