前循环大血管闭塞患者磁共振T2-FLAIR特征与侧支循环及溶栓治疗预后的相关性  

Correlation between T2-FLAIR characteristics and collateral circulation and prognosis of thrombolytic therapy for patients with anterior circulation large vessel occlusion

作　　者：张磊 于敏 隋旭蕾 ZHANG Lei;YU Min;SUI Xulei(Yantaishan Hospital,Yantai 264003,China)

机构地区：[1]烟台山医院,山东烟台264003

出　　处：《中国实用神经疾病杂志》2025年第4期409-414,共6页Chinese Journal of Practical Nervous Diseases

基　　金：烟台市科技创新发展计划项目(编码:2021YD036)。

摘　　要：目的探讨前循环大血管闭塞患者T2液体衰减反转恢复成像(T2-FLAIR)特征与侧支循环和溶栓治疗预后的相关性。方法选取2020-01—2023-03烟台山医院的149例前循环大血管闭塞患者为研究对象,所有患者均接受MRI检查获取T2-FLAIR特征,分析前循环大血管闭塞患者T2-FLAIR特征与侧支循环的相关性。将纳入的患者根据预后情况分为预后良好组和预后不良组,采用Logistic回归分析前循环大血管闭塞患者T2-FLAIR特征与溶栓治疗预后的相关性。结果149例前循环大血管闭塞患者在出院后为期6个月的随访中,32例患者mRS≤2分,纳入预后良好组,117例患者mRS≥3分,纳入预后不良组。Logistic回归分析显示,入院时NIHSS评分(OR=1.319)、发病至就诊时间(OR=1.905)、HVS分级(Ⅰ级)(OR=0.044)与侧支循环评分(OR=0.421)均与前循环大血管闭塞患者溶栓治疗预后有相关性(P<0.05),在排除其他混杂因素后HVS分级仍与前循环大血管闭塞患者溶栓治疗预后显著相关,ROC曲线下面积分别为0.713、0.683、0.719、0.713。Spearman相关系数分析显示,HVS分级与侧支循环评分呈正相关(r=0.442,P<0.001)。结论前循环大血管闭塞患者T2-FLAIR特征HVS分级与侧支循环情况及溶栓治疗预后显著相关,可用于前循环大血管闭塞患者侧支循环及预后的评估。Objective To investigate the correlation between T2-fluid attenuated inversion recovery imaging(T2-FLAIR)characteristics and the collateral circulation and prognosis of thrombolytic therapy for patients with anterior circulation large vessel occlusion(LVO).Methods From January 2020 to March 2023,149 patients with anterior circulation LVO in the Yantaishan Hospital were selected as the research objects.All patients underwent MRI to obtain T2-FLAIR features,which were used to analyze the correlation between T2-FLAIR features and collateral circulation of patients with anterior circulation LVO.The included patients were divided into two groups according to their prognosis:good prognosis group and poor prognosis group.Logistic regression was used to analyze the correlation between T2-FLAIR characteristics of patients with anterior circulation LVO and the prognosis of thrombolytic therapy.Results During the 6-month follow-up of 149 patients after discharge,32 patients were included in the good prognosis group,and 117 patients were included in the poor prognosis group.Logistic regression analysis showed that NIHSS score at admission(OR=1.319),time from onset to treatment(OR=1.905),HVS classification(gradeⅠ)(OR=0.044)and collateral circulation score(OR=0.421)were all related to the prognosis of patients with anterior circulation LVO after thrombolytic therapy(all P<0.05).After excluding other confounding factors,HVS classification was still significantly related to the prognosis of thrombolytic therapy in patients with anterior circulation LVO.The areas under ROC curve were 0.713,0.683,0.719 and 0.713,respectively.Spearman correlation coefficient analysis showed that HVS classification was positively correlated with collateral circulation score(r=0.442,P<0.001).Conclusion T2-FLAIR HVS classification of patients with anterior circulation LVO is significantly related to collateral circulation and prognosis of thrombolytic therapy,and can be used to evaluate collateral circulation and prognosis of patients with anterior

关 键 词：大血管闭塞 前循环 侧支循环 溶栓 T2液体衰减反转恢复序列 磁共振成像 

分 类 号：R743[医药卫生—神经病学与精神病学]