摘要
目的探讨急性大血管闭塞性脑卒中患者颅内动脉钙化情况与机械取栓术后预后的关系。方法选取147例接受机械取栓术的急性大血管闭塞性脑卒中患者作为研究对象,通过CT检查评估患者颅内动脉钙化长度、钙化密度及钙化部位。根据颅内动脉钙化情况,将患者分为症状性颅内动脉钙化组42例、无症状性颅内动脉钙化组24例和非颅内动脉钙化组81例。采用多元Logistic回归分析探讨颅内动脉钙化情况与患者机械取栓术后临床预后的关系。结果与无症状性颅内动脉钙化组、非颅内动脉钙化组患者相比,症状性颅内动脉钙化组患者年龄更大,合并高血压者占比更高,术中机械取栓后接受补救性血管成形术/支架置入术者占比更高,差异有统计学意义(P<0.05)。症状性颅内动脉钙化组与无症状性颅内动脉钙化组患者的钙化部位比较,差异有统计学意义(P<0.05),但2组患者颅内动脉钙化长度和钙化密度比较,差异无统计学意义(P>0.05)。多元Logistic回归分析结果显示,校正潜在混杂因素后,症状性颅内动脉钙化是血管再通失败(校正OR=8.67,95%CI:2.39~15.68,P<0.001)、需要补救性介入治疗(校正OR=6.46,95%CI:2.26~14.29,P<0.001)及神经功能恢复不佳(校正OR=3.91,95%CI:1.38~10.16,P=0.023)的独立危险因素。结论症状性颅内动脉钙化与急性大血管闭塞性脑卒中患者机械取栓术后临床预后不佳密切相关,术前颅内动脉钙化评估结果对急性大血管闭塞性脑卒中患者血管再通治疗策略的选择至关重要。
Objective To investigate the relationship between intracranial arterial calcification and prognosis after mechanical thrombectomy in patients with acute large vessel occlusion stroke.Methods A total of 147 patients with acute large vessel occlusion stroke who underwent mechanical thrombectomy were enrolled in this study.The length,density,and location of intracranial arterial calcification were evaluated by CT.Based on the intracranial arterial calcification status,patients were divided into three groups:symptomatic intracranial arterial calcification group(n=42),asymptomatic intracranial arterial calcification group(n=24),and no intracranial arterial calcification group(n=81).Multivariate Logistic regression analysis was performed to explore the relationship between intracranial arterial calcification and clinical outcomes after mechanical thrombectomy.Results Compared with patients in the asymptomatic and no intracranial arterial calcification groups,patients in the symptomatic intracranial arterial calcification group,had older age,a higher proportion of hypertension,and required more rescue angioplasty or stenting after mechanical thrombectomy(P<0.05).There was a statistically significant difference in the location of calcification between the symptomatic and asymptomatic intracranial arterial calcification groups(P<0.05),but no significant differences in the length and density of calcification between the two groups were observed(P>0.05).Multivariate Logistic regression analysis revealed that symptomatic intracranial arterial calcification was an independent risk factor for failed revascularization(adjusted OR=8.67,95%CI,2.39 to 15.68,P<0.001),the need for rescue interventional therapy(adjusted OR=6.46,95%CI,2.26 to 14.29,P<0.001),and poor neurological recovery(adjusted OR=3.91,95%CI,1.38 to 10.16,P=0.023)after adjusting for potential confounding factors.Conclusion Symptomatic intracranial arterial calcification is closely associated with poor clinical outcomes after mechanical thrombectomy in patients with
作者
杨涛
陈后勤
夏加琴
邵凌云
YANG Tao;CHEN Houqin;XIA Jiaqin;SHAO Lingyun(Department of Neurology,the First People's Hospital of Wuhu of Anhui Province,Wuhu,Anhui,241000)
出处
《实用临床医药杂志》
CAS
2024年第19期79-83,共5页
Journal of Clinical Medicine in Practice
基金
安徽省芜湖市卫生健康委重点科研项目(WHWJ2022z001)。
关键词
颅内动脉钙化
大血管闭塞
急性脑卒中
机械取栓
血管再通
intracranial arterial calcification
large vessel occlusion
acute stroke
mechanical thrombectomy
revascularization
