血清镁离子水平与急性大血管闭塞性卒中患者机械取栓后无效再通的相关性分析  

Analysis of the correlation between serum magnesium levels and ineffective recanalization after mechanical thrombectomy in patients with acute large vessel occlusion stroke

作　　者：欧志杰 仲崇科 王一轻 陈菊萍[1] 肖国栋[4] 曹勇军[4] 翟国杰 Ou Zhijie;Zhong Chongke;Wang Yiqing;Chen Juping;Xiao Guodong;Cao Yongjun;Zhai Guojie(Department of Neurology,Changshu Hospital Affiliated to Nanjing University of Chinese Medicine,Changshu 215500,China;Department of Epidemiology,Suzhou Medical College of Soochow University,Suzhou 215123;Department of Neurology,the Ninth People's Hospital of Suzhou,Suzhou 215200,China;Departmentof Neurology,the Second Affiliated Hospital of Soochow University,Suzhou 215004,China)

机构地区：[1]南京中医药大学常熟附属医院神经内科,常熟215500 [2]苏州大学苏州医学院公共卫生学院,苏州215123 [3]苏州市第九人民医院神经内科,苏州215200 [4]苏州大学附属第二医院神经内科,苏州215004

出　　处：《中华医学杂志》2025年第11期834-838,共5页National Medical Journal of China

基　　金：国家自然科学基金(82171296);2022年苏州市姑苏卫生人才科研项目(GSW2022098);2023年江苏省中医药局科技项目(MS2023096);2023年苏州市临床试验机构能力提升项目(SLT2023026);常熟市科学技术局课题(SYSD2019019)。

摘　　要：回顾性收集2016年7月至2023年12月期间,在常熟市中医院、苏州市第九人民医院和苏州大学附属第二医院接受机械取栓术的急性大血管闭塞性卒中患者312例。依据90 d改良Rankin量表(mRS)评分将患者分为有效再通组(mRS<3分)和无效再通组(mRS≥3分)。将血清镁离子水平按三分位分为T1(Mg^(2+)≤0.75 mmol/L)、T2(0.75 mmol/L<Mg^(2+)≤0.84 mmol/L)和T3(Mg^(2+)>0.84 mmol/L)三档,评估血清镁离子水平与无效再通的关系。采用多因素logistic回归模型对无效再通的相关因素进行分析。低血清镁离子水平(Mg^(2+)≤0.75 mmol/L)(OR=1.94,95%CI:1.03~3.64)、既往卒中史(OR=2.22,95%CI:1.04~4.75)、术前高血糖(OR=1.16,95%CI:1.05~1.29)和较低的Alberta卒中项目早期CT评分(ASPECTS)(OR=0.38,95%CI:0.20~0.72)是机械取栓术后无效再通的相关因素。T1组mRS≥3分的占比最高[65.1%(71/109)],T3组最低[51.0%(49/96)]。血清镁离子水平与患者的功能预后密切相关。Three hundred and twelve acute large vessel occlusion stroke patients who underwent mechanical thrombectomy at Changshu Hospital of Traditional Chinese Medicine,Suzhou Ninth People′s Hospital,and the Second Affiliated Hospital of Soochow University from July 2016 to December 2023 were retrospectively collected.The patients were divided into effective recanalization group(mRS<3)and ineffective recanalization(mRS≥3)group based on 90-day modified Rankin scale(mRS)scores.Serum magnesium levels were categorized into tertiles:T1(Mg^(2+)≤0.75 mmol/L),T2(0.75 mmol/L<Mg^(2+)≤0.84 mmol/L)and T3(Mg^(2+)>0.84 mmol/L),and the relationship between serum magnesium levels and ineffective recanalization was evaluated.Multivariable logistic regression model was used to analyze the related factors of ineffective recanalization.Low serum magnesium levels(Mg^(2+)≤0.75 mmol/L)(OR=1.94,95%CI:1.03-3.64),previous stroke history(OR=2.22,95%CI:1.04-4.75),pre-procedural hyperglycemia(OR=1.16,95%CI:1.05-1.29),and lower Alberta stroke early CT scores(ASPECTS)(OR=0.38,95%CI:0.20-0.72)were related risk factors for ineffective recanalization after mechanical thrombectomy.The proportion of patients with mRS scores of≥3 was highest in the T1 group[65.1%(71/109)]and lowest in the T3 group[51.0%(49/96)].Serum magnesium level is closely related to functional prognosis of patients.

关 键 词：镁 大血管闭塞性卒中 机械取栓 预后 无效再通 

分 类 号：R47[医药卫生—护理学]