摘要
目的研究急性大血管闭塞性脑卒中(ALVOS)患者再通后恶性脑水肿(MBE)的发生风险因素。方法回顾性选取2020年1月至2023年1月无锡市人民医院收治的100例ALVOS早期成功再通患者作为研究对象,按照是否出现MBE将其分为研究组(n=30)与对照组(n=70)。研究组为出现MBE患者,对照组为未出现MBE患者。比较两组患者的临床资料[年龄、性别构成比、高血压占比、糖尿病占比、入院时收缩压、入院时舒张压、血管闭塞部位、发病-再通时间、TOAST分型、美国国立卫生研究院卒中量表(NIHSS)评分、脑侧支循环分级],并采用二元Logistic回归分析ALVOS患者早期成功再通后MBE发生风险。结果两组患者的年龄、性别构成比、高血压占比、糖尿病占比、入院时收缩压、入院时舒张压、血管闭塞部位、发病-再通时间、TOAST分型比较,差异均无统计学意义(P>0.05);研究组患者NIHSS评分为(18.24±2.06)分,明显高于对照组[(16.03±1.95)分],脑侧支循环分级明显差于对照组,差异均有统计学意义(P<0.05)。多因素分析显示,脑侧支循环分级2级为ALVOS患者早期成功再通后MBE发生的独立影响因素(OR=0.088,95%CI:0.010~0.812,P<0.05)。结论ALVOS早期成功再通后发生MBE患者的NIHSS评分、不良脑侧支循环发生率较ALVOS再通后未发生MBE患者明显更高,且ALVOS患者早期成功再通后发生MBE的独立危险因素为脑侧支循环分级2级。
Objective To investigate the risk factors of malignant cerebral edema(MBE)after early successful recanalization in patients with acute great vascular occlusive stroke(ALVOS).Methods A retrospective analysis was conducted,and 100 patients with early successful recanalization of ALVOS admitted to Wuxi People's Hospital from January 2020 to January 2023 were observed.According to whether there was MBE,the patients were divided into study group(n=30)and control group(n=70).The study group was the patients with MBE,and the control group was the patients without MBE.The clinical data[age,sex composition,proportion of hypertension,proportion of diabetes,systolic blood pressure at admission,diastolic blood pressure at admission,vascular occlusion site,onset recanalization time,TOAST classification,National Institute of Health stroke scale(NIHSS)score,cerebral collateral circulation classification]of the two groups were compared,and the risk of MBE in ALVOS patients after early successful recanalization was analyzed using binary logistic regression method.Results There were no statistically significant differences in age,gender,number of hypertension cases,number of diabetes cases,systolic blood pressure at admission,diastolic blood pressure at admission,location of vascular occlusion,onset-recalculation time and TOAST score between the two groups(P>0.05).The NIHSS score in the study group was(18.24±2.06)points,which was significantly higher than that in the control group[(16.03±1.95)points],and the score of collateral circulation in the study group was significantly lower than that in the control group,the differences were statistically significant(P<0.05).Multivariate analysis showed that grade 2 of cerebral collateral circulation was an independent influencing factor for the occurrence of MBE in ALVOS patients after early successful recanalization(OR=0.088,95%CI:0.010-0.812,P<0.05).Conclusion The NIHSS score and incidence of adverse collateral circulation in patients with MBE after ALVOS early successful recanalizati
作者
辛赛
霍薪利
吴红雪
XIN Sai;HUO Xin-li;WU Hong-xue(Department of Emergency,Wuxi People's Hospital,Wuxi Jiangsu 214023,China)
出处
《临床和实验医学杂志》
2023年第20期2142-2145,共4页
Journal of Clinical and Experimental Medicine
基金
江苏省科技计划项目(编号:2021GF-046)。
关键词
急性大血管闭塞性脑卒中
血管再通
恶性脑水肿
风险因素
脑侧支循环分级
Acute great vascular occlusive stroke
Recanalization
Malignant cerebral edema
Risk factors
Brachial circulation grading
