急性前循环大血管狭窄脑卒中患者不良预后的危险因素分析  

Analysis of risk factors for poor prognosis in stroke patients with acute anterior circulation stenosis of large blood vessels

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作  者:孙俊福[1] 张德智[1] 安小勤[1] 姜勇[1] 江静如 吴佳荣 储剑 SUN Junfu;ZHANG Dezhi;AN Xiaoqin;JIANG Yong;JIANG Jingru;WU Jiarong;CHU Jian(Anqing 116th Hospital/Navy Anqing Hospital,Anqing 246000,China)

机构地区:[1]安庆一一六医院(原海军安庆医院),安徽安庆246000

出  处:《中国实用神经疾病杂志》2024年第9期1066-1070,共5页Chinese Journal of Practical Nervous Diseases

摘  要:目的分析急性前循环大血管狭窄脑卒中患者不良预后的危险因素。方法回顾性选取2021-01—2023-09安庆一一六医院收治的急性前循环大血管狭窄脑卒中患者,将其中治疗后3个月随访评估为不良预后的23例患者纳入预后不良组,采用倾向匹配法从良好预后的患者中匹配46例患者纳入良好组。对比并分析2组患者的临床资料,构建风险模型。结果基线NIHSS评分≥13.705分、梗死核心区体积≥52.720 mL、入院收缩压≥160.060 mmHg为ALVSS患者不良预后的危险因素。rLMC评分≤9.429分为不良预后的保护因素,对于ALVSS患者不良预后具有中等评估价值(0.7<AUC≤0.9,P<0.05)。危险因素与保护因素联合构建的风险模型对于ALVSS患者不良预后具有较高的预估价值(AUC>0.9,P<0.05)。结论基线NIHSS偏高、梗死核心区体积较大、入院收缩压较高以及rLMC评分较低可提示急性前循环大血管狭窄脑卒中患者不良预后,可针对性给予干预,改善患者预后。Objective To analyze the risk factors for poor prognosis in stroke patients with acute anterior circulation stenosis.Methods Stroke patients with acute anterior circulation large vessel stenosis stroke admitted to Anqing 116th Hospital between January 2021 and September 2023 were retrospectively selected.Twenty-three patients with poor prognosis were included in the poor prognosis group after 3 months of follow-up evaluation after treatment,and 46 patients with good prognosis were matched into the good group using propensity matching method.The clinical data of two groups were compared and analyzed,and a risk model was constructed.Results Baseline NIHSS score≥13.705 points,infarct core volume≥52.720 mL,and admission systolic blood pressure≥160.060 mmHg were risk factors for poor prognosis in ALVSS patients.RLMC score≤9.429 is a protective factor for poor prognosis,and has moderate evaluation value for poor prognosis in ALVSS patients(0.7<AUC≤0.9,P<0.05).The risk model constructed by combining risk factors and protective factors has a high predictive value for adverse prognosis in ALVSS patients(AUC>0.9,P<0.05).Conclusion High baseline NIHSS,larger infarct core volume,higher admission systolic blood pressure,and lower rLMC score can indicate poor prognosis in stroke patients with acute anterior circulation macrovascular stenosis.Targeted interventions can be given to improve patient prognosis.

关 键 词:急性脑卒中 前循环大血管狭窄 预后 危险因素 风险模型 

分 类 号:R743.3[医药卫生—神经病学与精神病学]

 

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