摘要
目的探讨急性前循环大血管闭塞性脑卒中患者机械取栓术后颅内出血的影响因素。方法回顾性收集上海市浦东新区人民医院神经内科、苏州大学附属第二医院神经内科自2015年10月至2018年3月收治的行机械取栓治疗的116例急性前循环大血管闭塞性脑卒中患者的临床资料,根据患者术后有无颅内出血分为颅内出血组(n=31)和无颅内出血组(n=85),并采用单因素分析及多因素Logistic回归分析明确机械取栓术后颅内出血的独立影响因素。结果单因素分析显示颅内出血组在术前Alberta卒中项目早期CT(ASPECT)评分、基线收缩压、术前血糖水平等方面与无颅内出血组差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示,在校正基线格拉斯哥昏迷量表(GCS)评分后,术前ASPECT评分(OR=0.770,95%CI:0.610~0.971,P=0.027)、基线收缩压(OR=1.029,95%CI:1.005~1.054,P=0.017)、术前血糖水平(OR=1.177,95%CI:1.010~1.372,P=0.036)是机械取栓术后颅内出血的独立影响因素。结论术前ASPECT评分较低、基线收缩压较高、术前血糖水平较高的急性前循环大血管闭塞性脑卒中患者机械取栓术后易发生颅内出血。
Objective To explore the influencing factors for intracranial hemorrhage(ICH)in patients with acute large vessel occlusion stroke(ALVOS)of anterior circulation after mechanical thrombectomy(MT).Methods From October 2015 to March 2018,the clinical data of 116 patients with ALVOS of anterior circulation accepted MT were analyzed retrospectively in our hospitals.These patients were divided into ICH group(n=31)and non-ICH group(n=85)according to whether there was ICH after operation.Univariate and multivariate Logistic regression models were used to analyze the independent influencing factors for ICH after MT.Results Univariate analysis showed that there were significant differences in preoperative Alberta Stroke Program Early CT(ASPECT)scores,baseline systolic pressure,and preoperative blood glucose level between ICH group and non-ICH group(P<0.05).Multivariate analysis showed that after adjusting baseline Glasgow coma scale scores,preoperative ASPECT scores(OR=0.770,95%CI:0.610-0.0.971,P=0.027),baseline systolic pressure(OR=1.029,95%CI:1.005-1.054,P=0.017),preoperative blood glucose level(OR=1.177,95%CI:1.010-1.372,P=0.036)were independent influencing factors for ICH.Conclusion The patients with low preoperative ASPECT scores,high baseline systolic pressure,and high blood glucose are prone to have ICH after MT in patients with ALVOS of anterior circulation.
作者
任海兵
颜静
赵晓晖
邢婷婷
张健颖
肖国栋
曹勇军
Ren Haibing;Yan Jing;Zhao Xiaohui;Xing Tingting;Zhang Jianying;Xiao Guodong;Cao Yongjun(Department of Neurology,Pudong New District People's Hospital,Shanghai 201299,China;Department of Neurology,Second Affiliated Hospital of Soochow University,Suzhou 215004,China)
出处
《中华神经医学杂志》
CAS
CSCD
北大核心
2020年第9期890-896,共7页
Chinese Journal of Neuromedicine
关键词
缺血性脑卒中
前循环大血管闭塞
机械取栓
颅内出血
影响因素
Ischemic stroke
Large artery occlusion in anterior circulation
Mechanical thrombectomy
Intracranial hemorrhage
Influencing factor
