急性缺血性卒中核心CT灌注参数与预后的相关性研究  

The Correlation between Core CT Perfusion Parameters and Prognosis in Acute Ischemic Stroke

作　　者：任丽丽 王磊[1] REN Li-li;WANG Lei(Department of Critical Care Medicine,the First Affiliated Hospital of Harbin Medical University,Harbin 150001,Heilongjiang Province,China)

机构地区：[1]哈尔滨医科大学附属第一医院重症医学科,黑龙江哈尔滨150001

出　　处：《中国CT和MRI杂志》2025年第4期1-3,共3页Chinese Journal of CT and MRI

基　　金：江西省卫生健康委科技计划(20204737)。

摘　　要：目的急性缺血性卒中血管内治疗(EVT)前静脉溶栓(IVT)可引起脑出血,因而可评估急性缺血性卒中核心CT灌注参数可指导治疗及预后。方法建脑白质CT参数模型(WML),并用医院收治急性缺血性卒中患者进行验证,根据改良的Rankin分级(MRS)将DL-WML和WML-FAZ与症状性脑出血(SICH)和90天的功能结果相关联,回归模型采用共同优势比(COR/ACOR)评价。结果总共分析516例患者,DL-WML体积和WML-FAZ都与SICH和MRS相关。如果给予静脉内注射,则WML-FAZ与更多的脑出血相关(P=0.046)。如果给予静脉血栓治疗,两种WML测量方法都与更差的MRS无关。结论DL-WML体积和WML-FAZ与功能结局和SICH的关系相似,值得注意。Objective Intravenous thrombolysis(IVT)before endovascular treatment(EVT)for acute ischemic stroke can cause cerebral hemorrhage,thus evaluating the core CT perfusion parameters of acute ischemic stroke can guide treatment and prognosis.Methods A CT perfusion parameter model(WML)was established and validated with hospitalized acute ischemic stroke patients.DL-WML and WML-FAZ were correlated with symptomatic intracerebral hemorrhage(SICH)and 90 day functional outcomes based on the improved Rankin classification(MRS).The regression model was evaluated using a common odds ratio(COR/ACOR).Results A total of 516 patients were analyzed,and both DL-WML volume and WML-FAZ were associated with SICH and MRS.If given intravenously,WML-FAZ is associated with more cerebral hemorrhage(P=0.046).If venous thrombosis treatment is given,both WML measurement methods are not associated with poorer MRS.Conclusion The relationship between DL-WML volume and WML-FAZ with functional outcomes and SICH is similar and worth noting.

关 键 词：急性缺血性卒中 血管内治疗 前静脉溶栓 脑出血 

分 类 号：R722.151[医药卫生—儿科]