桥接治疗辅助血管内介入治疗对急性脑梗死的应用研究  

Application of bridge therapy assisted with endovascular therapy in acute cerebral infarction

作　　者：张铁山[1] 王冬梅 邢汝月 陈骏 ZHANG Tieshan;WANG Dongmei;XING Ruyue;CHEN Jun(Emergency Department,Affiliated Hospital of Yellow River University of Science and Technology,Zhengzhou,Henan 450000,China;Department of Neurology,First Affiliated Hospital of Nanyang Medical College,Nanyang,Henan 473000,China)

机构地区：[1]黄河科技学院附属医院急诊科,河南郑州450000 [2]南阳医学高等专科学校第一附属医院,神经内科,河南南阳473000

出　　处：《中国医学工程》2025年第2期44-48,共5页China Medical Engineering

基　　金：河南省医学科技攻关项目(LHGJ20201215)。

摘　　要：目的 观察桥接治疗辅助血管内介入治疗(EVT)急性脑梗死的临床效果。方法 该研究为前瞻性研究,选择黄河科技学院附属医院2022年1月至2023年12月收治的105例急性脑梗死患者作为研究对象,分组方式为电脑随机分组法。将入组患者分别列为EVT组(52例)和联合组(53例),EVT组直接实施EVT治疗,联合组采用桥接治疗辅助EVT治疗,比较两组患者的血管再通情况,脑血流动力学改善情况,神经功能恢复情况及预后情况。结果 联合组的血管再通率为88.68%(47/53),高于EVT组[73.08%(38/52)](P<0.05);联合组的脑血流量(CBF)、脑血容量(CBV)分别为(50.23±10.31) mL/(100g·min)、(4.49±1.31) mL/100g,均高于EVT组[(45.25±10.44) mL/(100g·min)、(3.62±0.79) mL/100g],低灌注强度比值(HIR)为(0.36±0.11),低于EVT组(0.76±0.25)(P<0.05);联合组的神经元特异性烯醇化酶(NSE)、中枢神经特异蛋白(S100β)分别为(8.61±1.46) ng/mL、(10.32±2.24) pg/mL,均低于EVT组[(10.66±2.39) ng/mL、(12.77±3.31) pg/mL](P<0.05);联合组的改良Rankin量表(mRS)评分为(3.44±0.45)分,低于EVT组[(4.25±1.72)分],改良Barthel指数(MBI)为(86.23±10.25)分,高于EVT组[(81.18±10.27)分](P<0.05);联合组的不良预后发生率为5.66%(3/53),低于EVT组[23.08%(12/52)](P<0.05)。结论 桥接治疗辅助EVT治疗能提高急性脑梗死的血管再通率,对促进患者脑血流动力、神经功能恢复并降低不良预后发生风险均有积极意义。【Objective】 To observe the clinical effect of bridging therapy in assisting endovascular therapy(EVT) in acute cerebral infarction.【Methods】 This study is a prospective study,and the study subjects were randomly selected from 105 cases of acute cerebral infarction admitted to the Affiliated Hospital of Yellow River University of Science and Technology from January 2022 to December 2023.The grouping method was computer randomization,and the enrolled patients were divided into the EVT group(52 cases) and the combination group(53 cases).The EVT group received EVT treatment directly,while the combination group received bridge therapy to assist EVT treatment.The vascular reperfusion,cerebral hemodynamic improvement,neurological function recovery,and prognosis of the two groups of patients were compared.【Results】 Under different treatment regimens,the vascular recanalization rate in the combination group was 88.68%(47/53),higher than the EVT group [73.08%(38/52)](P<0.05).The cerebral blood flow(CBF) and cerebral blood volume(CBV) of the combination group were 50.23±10.31 mL/(100g·min) and 4.49±1.31 mL/100g,higher than the EVT group [45.25±10.44 mL/(100g·min) and 3.62±0.79 mL/100g];the hypoperfusion intensity ratio(HIR) in the combination group(0.36±0.11) was lower than the EVT group(0.76±0.25)(P<0.05).The values of NSE and S100β in the combination group were 8.61±1.46 ng/mL and 10.32±2.24 pg/mL,lower than the EVT group(10.66±2.39 ng/mL and 12.77±3.31 pg/mL)(P<0.05).The modified Rankin Scale(mRS) score of the combination group(3.44±0.45) was lower than the EVT group(4.25±1.72),and the modified Barthel index(MBI) score(86.23±10.25) was higher than the EVT group(81.18±10.27)(P<0.05).The incidence of poor prognosis in the combination group was 5.66%(3/53),lower than the EVT group [23.08%(12/52)](P<0.05).【Conclusion】 Bridge therapy combined with EVT therapy can improve the vascular reperfusion rate of acute cerebral infarction,promote the recovery of cerebral hemodynamics and neurological fu

关 键 词：急性脑梗死 血管内介入治疗 桥接治疗 血管再通率 预后情况 

分 类 号：R743.3[医药卫生—神经病学与精神病学]