摘要
目的探讨毛细血管指数评分(CIS)评估急性前循环缺血性卒中患者侧支循环情况,评价CIS在急性前循环缺血性卒中血管内治疗中的价值。方法回顾性分析2015年2月—2018年12月就诊于安庆市第一人民医院行血管内治疗的52例急性前循环缺血性卒中患者。纳入患者行全脑数字减影血管造影完成CIS,分为充盈良好(fCIS组)27例和充盈不良(pCIS组)25例。根据改良Rankin量表(mRS)评分分为良好预后组24例(≤2分)和不良预后组28例(>3分)。单因素分析比较两组基线资料和临床资料,多因素Logistic回归分析CIS对预后结局的影响。结果fCIS组与pCIS组年龄、性别、糖尿病史、收缩压、心房颤动、高脂血症、美国国立卫生研究院卒中量表(NIHSS)评分、发病至血管再通时间(TTR)比较,差异无统计学意义(P>0.05),而扩散加权成像Alberta卒中早期CT评分(DWI-ASPECTS)、改良脑梗死溶栓实验分级(mTICI)≥Ⅱb患者比例比较,差异有统计学意义(P<0.05)。良好预后组与不良预后组年龄、性别、糖尿病史、收缩压、心房颤动、高脂血症、NIHSS评分、TTR比较,差异无统计学意义(P>0.05),而DWI-ASPECTS评分、≥Ⅱb及fCIS比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,mTICI[O^R=5.603(95%CI:2.035,21.447)]和DWI-ASPECTS评分[O^R=0.625(95%CI:0.472,0.826)]是血管内治疗预后的危险因素,而CIS[O^R=8.474(95%CI:2.478,32.516)]是其保护因素。结论CIS可用于评价脑组织灌注及毛细血管充盈情况,在EVT时增加CIS和DWI-ASPECT评分评价,对预测急性缺血性脑卒中患者的预后具有重要价值。
Objective To evaluate the ability of capillary index score(CIS)to evaluate collateral circulation in patients with acute anterior circulation ischemic stroke and the prognosis of endovascular treatment.Methods A retrospective analysis of 52 patients with acute anterior circulation ischemic stroke treated with endovascular treatment in the First People’s Hospital of Anqing City from February 2015 to December 2018.CIS performed with whole brain DSA before endovascular treatment showed 27 patients with good fCIS,25 patients with poorCIS(pCIS).According to Modified Rankin Scale(mRS)),there were 24 and 28 cases in the good(<2 points)and poor(>3 points)prognosis group.Univariate analysis was used to compare the baseline data and clinical data of two groups.Multivariate logistic regression analysis was performed to analyze the effect of CIS on prognosis.Results There was no significant difference between fCIS group and pCIS group in age,gender,history of diabetes,systolic blood pressure,atrial fibrillation,hyperlipidemia,NIHSS score,onset time to TIR(all P>0.05);the differences in DWIASPECTS score and mTICI≥IIb were statistically significant(all P<0.05);there were no significant differences in age,gender,history of diabetes mellitus,systolic blood pressure,atrial fibrillation,hyperlipidemia,NIHSS score,onset to revascularization time(TIR)between the good prognosis group and the poor prognosis group(all P>0.05);the differences in in DWI-ASPECTS score,mTICI≥IIb and fCIS were statistically significant(all P<0.05).Multivariate logistic regression analysis showed that the scores of mTICI[O^R=5.603,(95%CI:2.035,21.447)],DWI-ASPECTS[O^R=0.625,(95%CI:0.472,0.826)]and CIS[O^R=8.474,(95%CI:2.478,32.516)]were predictors of endovascular treatment outcome.Conclusion CIS can be used to evaluate brain perfusion and capillary filling,DWI-ASPECT score and CIS may be used to predict the prognosis of patients with acute ischemic stroke,while EVT is increasing.
作者
张良兵
操礼琼
何玮
Liang-bing Zhang;Li-qiong Cao;Wei He(Department of Neurology,The First People’s Hospital of Anqing,Anqing,Anhui 246004,China)
出处
《中国现代医学杂志》
CAS
2020年第4期44-49,共6页
China Journal of Modern Medicine
基金
安庆市自筹经费科技计划项目（No:2018Z006）
关键词
卒中
脑缺血
侧支循环
预后
stroke
cerebral ischemia
collateral circulation
prognosis
