摘要
目的分析急性前循环脑梗死患者机械取栓(MT)预后的影响因素。方法回顾性分析2018年1月至2021年3月陕西省人民医院收治的92例急性前循环脑梗死患者,以术后90 d改良Rankin量表(mRS)评分0~2分和3~6分将其分为预后良好组和预后不良组,各46例。比较两组的一般资料,并对单因素分析显示P<0.05的变量进行多因素Logistic回归分析,探讨影响MT预后的因素。结果两组的性别、居住地、婚姻状况、2型糖尿病、心房颤动、饮酒史、术前收缩压、术前舒张压、初级卒中中心转入、桥接、急性卒中治疗Org 10172试验(TOAST)分型、出血性转化比较,差异无统计学意义(P>0.05);两组的年龄、高血压、吸烟史、美国国立卫生研究院卒中量表(NIHSS)评分和改良脑梗死溶栓(mTICI)分级≥2b级比较,差异具有统计学意义(P<0.05)。多因素Logistic回归分析发现,术前NIHSS评分、术后第3天NIHSS评分是影响MT预后的独立危险因素(P<0.05)。结论术前NIHSS评分和术后第3天NIHSS评分较高会增加急性前循环脑梗死患者MT不良预后的发生率,临床应充分关注不同时间点NIHSS评分,以制定和调整治疗方案。
Objective To analyze the factors affecting the prognosis of mechanical thrombectomy(MT)in patients with acute anterior circulation cerebral infarction.Methods Retrospective analysis was performed on 92 patients with acute anterior circulation cerebral infarction admitted in Shaanxi Provincial People's Hospital from January 2018 to March 2021,and the patients were divided into good prognosis group and poor prognosis group according to modified Rankin Scale(mRS)score of 0-2 and 3-6 at 90 d after surgery,with 46 cases in each group.General data of the two groups were compared,and multivariate Logistic regression analysis was performed for variables with P<0.05 indicated by univariate analysis to explore the risk factors affecting the prognosis.Results There were no significant differences in gender,habitation,marital status,type 2 diabetes,atrial fibrillation,alcohol history,preoperative systolic blood pressure,preoperative diastolic blood pressure,transferred from a primary stroke center,bridge,Trial of Org 10172 in Acute Stroke Treatment(TOAST)somatotype and hemorrhagic transformation between the two groups(P>0.05);there were statistically significant differences in age,hypertension,smoking history,National Institute of Health Stroke Scale(NIHSS)score and modified Thrombolysis Incerebral Infarction(mTICI)grade≥2b between the two groups(P<0.05).The multivariate Logistic regression analysis showed that preoperative NIHSS score and NIHSS score on the third day after surgery were independent risk factors affecting the prognosis of MT(P<0.05).Conclusion High preoperative NIHSS score and NIHSS score on the third day after surgery can increase the incidence of MT poor prognosis in patients with acute anterior circulation cerebral infarction,and clinical attention should be paid to NIHSS score at different time points to formulate and adjust treatment plans.
作者
张强
崔小丽
蒋锋
胡军
李志伟
刘军
张虹
ZHANG Qiang;CUI Xiaoli;JIANG Feng;HU Jun;LI Zhiwei;LIU Jun;ZHANG Hong(No.1 Neurology Department,Shaanxi Provincial People's Hospital,Xi'an 710068,China)
出处
《临床医学研究与实践》
2023年第4期25-29,共5页
Clinical Research and Practice
基金
陕西省自然科学基础研究计划项目(No.2021JQ-903)。
关键词
急性前循环脑梗死
机械取栓
预后
改良脑梗死溶栓分级
acute anterior circulation cerebral infarction
mechanical thrombetomy
prognosis
modified Thrombolysis Incerebral Infarction grade
