摘要
目的探讨血管内治疗术后24 h美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分对急性基底动脉闭塞(acute basilar artery occlusion,ABAO)患者转归的预测价值。方法回顾性连续纳入2019年1月至2020年12月在胜利油田中心医院神经内科接受血管内治疗的ABAO患者。根据发病后90 d时改良Rankin量表评分分为转归良好组(0~3分)和转归不良组(4~6分)以及存活组和死亡组,分别比较组间人口统计学和临床资料。采用多变量logistic回归分析确定临床转归和死亡的独立影响因素。采用受试者工作特征(receiver operating characteristic,ROC)曲线评估术后24 h NIHSS评分对转归的预测价值。结果共纳入35例ABAO患者,年龄62岁(四分位数间距56~66岁),男性28例(80%);19例(54.3%)转归良好,16例(45.7%)转归不良,其中死亡7例(20.0%)。单变量分析显示,转归良好组高血压、低密度脂蛋白胆固醇、空腹血糖、侧支循环分级、血管再通情况以及术后24 h NIHSS评分与转归不良组相比差异有统计学意义(P均<0.05)。多变量logistic回归分析显示,术后24 h NIHSS评分与转归不良存在独立相关性(优势比1.131,95%置信区间1.017~1.258;P=0.023)。多变量分析未发现死亡的独立影响因素。ROC曲线分析显示,术后24 h NIHSS评分预测转归不良的曲线下面积为0.814(95%置信区间0.668~0.960;P=0.011),最佳截断值为19分,对应的敏感性和特异性分别为85.7%和71.4%。结论接受血管内治疗的ABAO患者术后24 h NIHSS评分对90 d转归不良具有良好的预测价值。
Objective To investigate the predictive value of the National Institutes of Health Stroke Scale(NIHSS)score at 24 h after endovascular treatment on the outcomes in patients with acute basilar artery occlusion(ABAO).Methods Consecutive patients with ABAO received endovascular treatment at the Department of Neurology,Shengli Oilfield Central Hospital from January 2019 to December 2020 were retrospectively included.According to the modified Rankin Scale scores at 90 days after onset,the patients were divided into a good outcome group(0-3)and a poor outcome group(4-6),as well as a survival group and a death group.The demographic and clinical data between the groups were compared respectively.Multivariate logistic regression analysis was use to identify independent influencing factors for clinical outcomes and mortality.The predictive value of postprocedural 24 h NIHSS score on the outcomes was evaluated using the receiver operating characteristic(ROC)curves.Results A total of 35 patients with ABAO were included.Their age was 62 years(interquartile range,56-66 years),and 28 patients were males(80%);19(54.3%)had a good outcome,16(45.7%)had a poor outcome,and 7(20.0%)died.Univariate analysis showed that there were statistically significant differences in hypertension,low-density lipoprotein cholesterol,fasting blood glucose,collateral circulation grading,vascular recanalization,and postprocedural 24 h NIHSS scores between the good outcome group and the poor outcome group(all P<0.05).Multivariate logistic regression analysis showed that the postprocedural 24 h NIHSS score was independently correlated with the poor outcome(odds ratio 1.131,95%confidence interval 1.017-1.258;P=0.023).Multivariate analysis did not find the independent influencing factors for death.ROC curve analysis showed that the area under the curve of the postprocedural 24 h NIHSS score for predicting poor outcome was 0.814(95%confidence interval 0.668-0.960;P=0.011).The optimal cutoff value was 19 points,and the corresponding sensitivity and specificit
作者
李妍
柳蕾
李画画
高宗恩
Li Yan;Liu Lei;Li Huahua;Gao Zongen(Binzhou Medical College,Yantai 264003,China;Neurointensive Care Unit,Shengli Oilfield Central Hospital,Dongying 257034,China;Department of Internal Medicine,Hospital of China University of Petroleum(East China),Qingdao 266580,China;Department of Neurology,Shengli Oilfield Central Hospital,Dongying 257034,China)
出处
《国际脑血管病杂志》
2023年第4期241-247,共7页
International Journal of Cerebrovascular Diseases
基金
国家重点研发项目(2016YFC1301502)。
关键词
缺血性卒中
动脉闭塞性疾病
基底动脉
血管内手术
疾病严重程度指数
治疗结果
Ischemic stroke
Arterial occlusive diseases
Basilar artery
Endovascular procedures
Severity of illness index
Treatment outcome
