大脑中动脉高密度征在急性前循环大血管闭塞取栓治疗中的意义  

Significance of middle cerebral artery high density sign in thrombectomy for acute anterior circulation occlusion of large vessels

作　　者：井延涛[1] 李帅[1] 任玉伟 孙岩 刘政博 李彪 杨洋 岳新灿[1] JING Yan-tao;LI Shuai;REN Yu-wei;SUN Yan;LIU Zheng-bo;LI Biao;YANG Yang;YUE Xin-can(Neurological Intensive Care Unit,Zhoukou Central Hospital,Zhoukou Henan 466000,China)

机构地区：[1]周口市中心医院NSICU,河南周口466000

出　　处：《医药论坛杂志》2025年第4期388-391,397,共5页Journal of Medical Forum

基　　金：河南省基础与前沿技术研究计划项目(142300410418)。

摘　　要：目的探讨大脑中动脉高密度征(hyperdense middle cerebral artery sign,HMCAS)在急性大血管闭塞中的意义及对机械取栓治疗预后的影响。方法选取2018年2月至2020年7月于河南省周口市中心医院就诊的164例急性前循环大血管闭塞患者作为研究对象,收集临床相关资料进行回顾性分析,根据术前头颅CT检查结果,分为HMCAS组(n=75)和No-HCAS(n=89),比较两组在卒中入院NIHSS评分、取栓次数、术后血管成功再通率、术后梗死面积,90 d良好预后率、出血转化率与病死率。结果HMCAS组与No-HCAS组到院NIHSS评分分别是18和16(P=0.001);取栓次数≤3次分别是81.09%和92.86%(P<0.001);术后血管再通率分别是86.35%和82.23%(P=0.169),术后梗死面积分别是[43.49(15.79,112.63)VS 31.36(6.79,100.62),P=0.010];症状性出血转化率分别是5.82%和5.06%(P=0.680),死亡率分别是18.55%和17.26%(P=0.680),良好预后率(mRS≤2)分别为33.94%和39.29%(P=0.174)。结论HMCAS可以预测卒中严重程度,增加了术中取栓次数,对于预后和死亡率则无明显影响。Objective To investigate the significance of hyperdense middle cerebral artery sign(HMCAS)in acute large vessel occlusion and its effect on the prognosis of mechanical thrombectomy.Methods A total of 164 patients with acute anterior circulation large vessel occlusion,treated at Zhoukou Central Hospital of Henan Province between February 2018 and July 2020,were selected as research subjects.Clinical data pertinent to these cases were retrospectively analyzed.According to preoperative head CT examination results,they were divided into HMCAS group(n=75)and NO-HCAS group(n=89).NIHSS score,thrombus removal times,postoperative successful vascular recanalization rate and postop⁃erative infarct area were compared between the two groups.Good prognosis rate,bleeding conversion rate and mortality at 90 days.Results NIHSS scores of HMCAS group and NO-HCAS group were 18 and 16(P=0.001),respectively.The Times of thrombectomy≤3 were 81.09%and 92.86%(P<0.001);the postoperative vascular recanalization rates were 86.35%and 82.23%(P=0.169),and the postoperative infarct area was 43.49(15.79,112.63)VS 31.36(6.79,100.62),(P=0.010),respectively.Symptom bleeding conversion rate was 5.82%and 5.06%(P=0.680),mortality rate was 18.55%and 17.26%(P=0.680),good prognosis rate(mRS≤2)was 33.94%and 39.29%(P=0.174).Conclusion Middle cerebral artery high density can predict the severity of stroke and increase the number of thrombolectomy,but it has no significant effect on prognosis and mortality.

关 键 词：大血管闭塞 大脑中动脉高密度征 机械取栓 

分 类 号：R816.1[医药卫生—放射医学]