TOAST分型在HMCAS急性缺血性卒中预后判断的价值研究  

The value of TOAST typing in predicting the prognosis of acute ischemic stroke in HMCAS

作　　者：肖根香 杨欢欢 赖婷 何清雄 黄龙深 曾国勇[2] Xiao Genxiang;Yang Huanhuan;Lai Ting;He Qingxiong;Huang Longshen;Zeng Guoyong(Department of Neurology,Shicheng County People's Hospital,Ganzhou,Jiangxi 342700;Department of Neurology,Ganzhou People's Hospital,Ganzhou City,Jiangxi Province 342100)

机构地区：[1]石城县人民医院神经内科,江西赣州342700 [2]赣州市人民医院神经内科,江西赣州342100

出　　处：《青岛医药卫生》2024年第4期294-298,共5页Qingdao Medical Journal

基　　金：赣州市卫生健康委科研计划项目(编号:GZWJW202402416)。

摘　　要：目的分析TOAST分型对HMCAS急性缺血性脑卒中患者预后的判断价值。方法选取2021年12月至2023年12月于我院行机械取栓(MT)治疗的184例急性缺血性脑卒中(HMCAS阳性)患者为研究对象,根据术前及术后辅助检查明确HMCAS急性缺血性卒中TOAST分型,并依据TOAST分型分组。比较不同TOAST分型患者一般资料、临床资料、术后情况及NIHSS评分、mRS评分。结果不同TOAST分型患者年龄、性别等方面无明显统计学差异(P>0.05)。酗酒、卒中家族史、同型半胱氨酸血症情况在不同TOAST分型中分布无统计学差异(P>0.05);吸烟、高血压、高血脂、糖尿病、冠心病及尿酸水平在不同TOAST分型中分布具有统计学差异(P<0.05)。mTICI分级、症状性颅内出血在不同TOAST分型中分布具有统计学差异(P<0.05)。SOE组患者例数较少未进一步统计分析;与其他TOAST分型患者相比,CE组术前、术后2h NIHSS评分以及术后3个月mRS评分明显较高,且差异具有统计学意义(P<0.05);与其他TOAST分型患者相比,SAA组术前、术后2h NIHSS评分以及术后3个月mRS评分明显较低,且差异具有统计学意义(P<0.05)。结论TOAST分型有助于评估急性缺血性脑卒中(HMCAS阳性)患者机械取栓(MT)治疗的预后情况。Objective To analyze the prognostic value of TOAST typing in patients with acute ischemic stroke caused by HMCAS.Methods 184 patients with acute ischemic stroke(HMCAS positive)who underwent mechanical thrombectomy(MT)treatment in our hospital from December 2021 to December 2023 were selected as the study subjects.The TOAST classification of HMCAS acute ischemic stroke was determined based on preoperative and postoperative auxiliary examinations and grouped according to the TOAST classification.Compare the general information,clinical data,postoperative condition,NIHSS score,and mRS score of patients with different TOAST subtypes.Results There was no significant statistical difference in age,gender,and other aspects among patients with different TOAST subtypes(P>0.05).There was no statistically significant difference in the distribution of alcohol abuse,family history of stroke,and homocysteinemia among different TOAST subtypes(P>0.05);The distribution of smoking,hypertension,hyperlipidemia,diabetes,coronary heart disease and uric acid levels in different TOAST classifications was statistically different(P<0.05).The distribution of mTICI grading and symptomatic intracranial hemorrhage showed statistical differences among different TOAST subtypes(P<0.05).The number of patients in the SOE group was relatively small and further statistical analysis was not conducted;Compared with other TOAST subtypes,the CE group had significantly higher preoperative and 2-hour postoperative NIHSS scores,as well as 3-month postoperative mRS scores,and the differences were statistically significant(P<0.05);Compared with other TOAST subtypes,the SAA group had significantly lower preoperative and 2-hour postoperative NIHSS scores,as well as 3-month postoperative mRS scores,and the differences were statistically significant(P<0.05).Conclusion TOAST typing is helpful in evaluating the prognosis of mechanical thrombectomy(MT)treatment in patients with acute ischemic stroke(HMCAS positive).

关 键 词：TOAST分型 急性缺血性卒中 大脑中动脉高密度征 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]