ASPECT评分联合NLR对急性大血管闭塞性卒中机械取栓预后的预测价值  

Prognostic value of ASPECT score combined with NLR in mechanical thrombectomy of acute large vascular occlusive stroke

作　　者：郝佳妮 许娟娟 骆嵩 HAO Jiani;XU Juanjuan;LUO Song(Department of Neurology,The First Affiliated Hospital of Bengbu Medical University,Bengbu Anhui 233004,China)

机构地区：[1]蚌埠医科大学第一附属医院神经内科,安徽蚌埠233004

出　　处：《蚌埠医学院学报》2024年第11期1430-1433,共4页Journal of Bengbu Medical College

基　　金：安徽省蚌埠市科技创新指导类项目(20230131);安徽省“江淮名医”培育工程项目(2022)。

摘　　要：目的:探究Alberta卒中项目早期CT(ASPECT)评分联合中性粒细胞/淋巴细胞比值(NLR)对急性大血管闭塞性缺血性卒中(AIS-LVO)机械取栓预后的预测价值。方法:回顾性分析84例经过机械取栓治疗的AIS-LVO病人临床资料,根据90 d mRS分数分为预后良好组(n=32)和预后不良组(n=52)。比较2组临床、影像和实验室基本资料。分析术前ASPECT评分和术后NLR与机械取栓病人术后90 d预后不良的关系及其预测病人预后不良的价值。结果:预后不良组在后循环闭塞、术前NIHSS评分、术后NLR、症状性颅内出血方面均高于预后良好组,术前ASPECT评分低于预后良好组(P<0.05~P<0.01)。多因素logistic回归分析显示,术前ASPECT评分降低、术后NLR升高、症状性颅内出血是影响病人预后的独立危险因素(P<0.05~P<0.01)。术后NLR联合ASPECT评分预测AIS-LVO病人取栓术后预后不良的AUC为0.913,高于ASPECT评分和术后NLR单独预测结果(AUC分别为0.768、0.888,P<0.05)。结论:术前ASPECT评分降低、术后NLR升高、症状性颅内出血与AIS-LVO病人机械取栓不良预后有关,术前ASPECT评分联合术后NLR可较好的预测不良预后的发生。Objective:To investigate the prognostic value of the Alberta stroke program early CT(ASPECT)score combined with neutrophil/lymphocyte ratio(NLR)in the prediction of mechanical thrombolysis in acute large vessel occlusive ischemic stroke(AIS-LVO).Methods:The clinical data of 84 AIS-LVO patients treated with mechanical thrombolysis were retrospectively analyzed,and the patients were divided into the good prognosis group(n=32)and poor prognosis group(n=52)according to the 90-day mRS score.The basic clinical,imaging,and laboratory data were compared between two groups.To analyze the association of preoperative ASPECT score and postoperative NLR with poor prognosis at 90-day postperatively in patients with mechanical thrombolysis and its value in predicting poor prognosis.Results:The posterior circulation occlusion,preoperative NIHSS score,postoperative NLR and symptomatic intracranial hemorrhage in the poor prognosis group were higher than those in good prognosis group,and the preoperative ASPECT score was lower than that in good prognosis group(P<0.05 to P<0.01).The results of multifactorial logistic regression analysis showed that the low preoperative ASPECT score,high postoperative NLR and symptomatic intracranial hemorrhage were the independent risk factors affecting patients′prognosis(P<0.05 to P<0.01).The AUC of postoperative NLR combined with ASPECT score to predict poor prognosis after thrombectomy in AIS-LVO patients was 0.913,which was higher than the results predicted by ASPECT score and postoperative NLR alone(AUC of 0.768 and 0.888,respectively,P<0.05).Conclusions:Decreasing the preoperative ASPECT score,increasing postoperative NLR and symptomatic intracranial hemorrhage are associated with the poor prognosis of mechanical thrombolysis in patients with AIS-LVO,and the preoperative ASPECT score combined with postoperative NLR can better predict the occurrence of poor prognosis.

关 键 词：急性大血管闭塞性缺血性卒中 机械取栓 中性粒细胞/淋巴细胞比值 Alberta卒中项目早期CT评分 

分 类 号：R651.12[医药卫生—外科学]