摘要
目的分析245例慢性颅内动脉闭塞患者在不同糖化血红蛋白(HbA1c)水平下接受血管内治疗的临床结果。方法血浆HbA1c>6.5%定义为高HbA1c。记录分析主要功能指标为不同HbA1c水平下接受血管内开通术后、随访期患者改良Rankin量表(mRS)评分,次要功能指标为开通成功率,术后、随访期美国国立卫生研究院卒中量表(NIHSS)评分、并发症发生率及病死率。结果 245例患者中85例(34.7%)HbA1c>6.5%,160例(65.3%)≤6.5%。两组患者间术前、术后、随访期NIHSS评分、mRS评分差异均无统计学意义(P>0.05),但术后、随访期均较术前明显改善(P<0.05)。HbA1c≤6.5%组开通成功率、并发症发生率和病死率均优于HbA1c>6.5%组(P<0.05),术后3个月并发症发生率和病死率仍低于HbA1c> 6.5%组(P<0.05)。HbA1c≤6.5%组再通后并发症发生概率较低。结论高HbA1c水平可能增加慢性颅内动脉闭塞患者病死率和并发症,更可能导致介入再通术后出现并发症。
Objective To analyze the clinical outcomes of endovascular treatment for chronic intracranial arterial occlusion with different glycated hemoglobin(HbA1c) levels. Methods A total of 245 patients with chronic intracranial arterial occlusion, who had different HbA1c levels and received endovascular treatment, were enrolled in this study. Plasma HbA1c level >6.5% was defined as high HbA1c level. The main functional indicator was post-recanalization modified Rankin scale(mRS) score during followup period. The secondary functional indicators included success rate of recanalization, post-recanalization National Institutes of Health Stroke Scale(NIHSS) score during follow-up period, incidence of complications and mortality. The results of above indicators were recorded and analyzed. Results Of 245 patients with chronic intracranial arterial occlusion, 85(34.7%) had a HbA1c level >6.5%(high HbA1c group) and 160 had a HbA1c level ≤6.5%(low HbA1c group). There were no statistically significant differences in preoperative,postoperative, follow-up NIHSS score and mRS score between the two groups(P>0.05), but in both groups the postoperative as well as follow-up NIHSS scores and mRS scores were remarkably improved when compared with the preoperative ones(P<0.05). The success rate of recanalization, incidence of complications and mortality in the low HbA1c group were prominently better than those in the high HbA1c group(P<0.05), and 3 months after endovascular treatment the incidence of complications and mortality in the low HbA1c group were still better than those in the high HbA1c group(P<0.05). In the low HbA1c group, the incidence of complications after recanalization was very low. Conclusion High HbA1c level may increase the mortality and complications in patients with chronic intracranial arterial occlusion, and high HbA1c level is more likely to cause complications in patients receiving endovascular interventional recanalization treatment.(J Intervent Radiol,2021, 30: 976-979)
作者
孟庆斌
白京岳
刘朝
魏森
管生
MENG Qingbin;BAI Jingyue;LIU Chao;WEI Sen;GUAN Sheng(Department of Neurointervention,First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan Province 450052,China)
出处
《介入放射学杂志》
CSCD
北大核心
2021年第10期976-979,共4页
Journal of Interventional Radiology
关键词
血管内治疗
动脉闭塞
糖化血红蛋白
预后
endovascular treatment
arterial occlusion
glycated hemoglobin
prognosis
