摘要
目的探讨影响脑大动脉急性闭塞血管内再通远期疗效的因素。方法回顾性分析2014年1月至2016年12月南京军区南京总医院神经内科卒中登记系统收录的脑大血管急性完全闭塞患者的临床资料,筛选符合入组标准的患者55例,以发病3个月改良Rankin量表(Modified Rankin Scale,MRS)评分0~1分定义为预后良好,分析影响其预后的因素。结果多因素回归分析提示低血钾(OR值0.46,95%CI:0.003~0.625,P=0.021)及术前高收缩压(OR值1.048,95%CI:1.006~1.091,P=0.024)为其不良预后的独立危险因素。血钾截断值3.91 mmol/L,受试者工作特征(ROC)曲线下面积0.692(95%CI:0.553~0.809),敏感性70.0%,特异性60.0%。收缩压截断值150 mm Hg,ROC曲线下面积0.705(95%CI:0.567~0.820),敏感性45.0%,特异性为93.3%。结论血钾及术前收缩压与急性脑大血管闭塞血管内再通治疗的远期预后相关,血钾低于3.91 mmol/L及收缩压高于150 mm Hg为血管内治疗预后不良的独立危险因素。
Objective To explore the factors that affect the outcomes of acute stroke patients who with large artery occlusion（ LAO） after endovascular recanalization. Methods 55 patients with acute cerebral artery occlusion between January 2014 and December 2016 were screened from Nanjing Stroke Registry Program in line with the including and excluding criteria. 90-day modified Rankin scale（ MRS） 0-1 was defined as a good prognosis. The factors related to the prognosis were retrospectively analyzed.Results The results of multivariate regression analysis showed the low pre-operation potassium concentration（ OR： 0. 46,95% CI：0.003-0.625,P = 0.021） and high SBP（ OR： 1.048,95% CI： 1. 006-1. 091,P = 0. 024） were independent risk factors of the poor long-term outcomes of the acute ischemic patients with endovascular recanalization. The cut-off value of serum potassium was 3. 91 mmol/L and the area under the ROC curve was 0.692（ 95% CI： 0.553-0.809）,the sensitivity was 70.0%,the specificity was 60.0%.The cut-off value of SBP was 150 mm Hg and the area under the ROC curve was 0.705（ 95% CI： 0.567-0.820）,the sensitivity was45.0%,the specificity was 93.3%. Conclusion Pre-operation serum potassium ≤3. 91 mmol/L and SBP 150 mm Hg were independent risk factors of the poor long-term prognosis of patients with LAO after endovascular recanalization.
作者
王颖
单婉莹
胡挺
张仁良
WANG Ying;SHAN Wan-ying;HU Ting;ZHANG Ren-liang(Department of Neurology, Jinling Hospital, Nanjing University School of Medicine/Nanjing General Hospital of Nanjing Military Region, PLA , Nanjing 210002, Jiangsu , China)
出处
《东南国防医药》
2018年第3期250-253,共4页
Military Medical Journal of Southeast China
关键词
缺血性脑卒中
血管内治疗
收缩压
血钾
预后
ischemic stroke
endovascular recanalization
systolic blood pressure
potassium concentration
prognosis
