中国医药科学2023，Vol.13Issue(24)：135-139,5.DOI:10.20116/j.issn2095-0616.2023.24.32
急性前循环脑梗死患者介入治疗预后的影响因素分析
Analysis of influencing factors on the prognosis of interventional treatment in patients with acute anterior circulation cerebral infarction
摘要
Abstract
Objective To analyze the influencing factors on the prognosis of interventional treatment in patients with acute anterior circulation cerebral infarction(AACI).Methods A total of 162 patients with AACI admitted to the Neurological department of the Affiliated Hospital of Yangzhou University from September 2019 to March 2021 were selected as the study subjects,who were treated with drug thrombolysis,mechanical thrombectomy,or combined treatment.Head CT examination was performed immediately and 24 hours after treatment,and the patients were divided into a bleeding group and a nonbleeding group based on the presence of high-density head CT at 24 hours after surgery.After 3 months of treatment,the patient's prognosis was assessed using the modified Rankin scale(mRS).A mRS score of≤2 indicated a good prognosis,while a score of≥3 indicated a poor prognosis.The age,gender,past medical history,preoperative alberta stroke program early CT score(ASPECT),admission NIHSS score,vascular occlusion site,and immediate postoperative high density and metal high density were compared between patients in the good prognosis and poor prognosis groups,the bleeding and nonbleeding groups.The factors that affect the prognosis of interventional treatment were included in a multivariate logistic regression analysis to obtain the influencing factors for the prognosis of interventional treatment in AACI patients.Results Among 162 AACI patients undergoing interventional treatment,77 had a good prognosis and 85 had a poor prognosis.The results of multivariate logistic regression analysis showed that low preoperative ASPECT score(OR=2.013,95%CI:0.801-5.059,P=0.037)and high discharge NIHSS score(OR=2.626,95%CI:1.880-3.667,P=0.000)were risk factors affecting the prognosis of AACI patients undergoing mechanical thrombectomy treatment.There were 61 cases in the postoperative bleeding group and 101 cases in the nonbleeding group.Logistic regression analysis showed that immediate postoperative high density(OR=1.121,95%CI:0.015-0.948,P=0.014)and metal high density(OR=2.062,95%CI:0.013-0.305,P=0.001)were risk factors for postoperative bleeding.Conclusion The prognosis of AACI patients treated with mechanical thrombectomy is closely related to the preoperative ASPECT score and discharge NIHSS score.Immediate postoperative high density and metal high density are risk factors for postoperative bleeding.Therefore,before choosing mechanical thrombectomy treatment,it is necessary to fully assess and take into account the specific situation of the patient,and provide targeted interventions to improve the prognosis of AACI patients.关键词
急性前循环脑梗死/术后即刻高密度/金属高密度/ASPECT评分/NIHSS评分Key words
Acute anterior circulation cerebral infarction/Immediate postoperative high density/Metal high density/ASPECT score/NIHSS score分类
医药卫生引用本文复制引用
王丽丽,周龙江..急性前循环脑梗死患者介入治疗预后的影响因素分析[J].中国医药科学,2023,13(24):135-139,5.基金项目
江苏省博士后科研资助计划项目(2020Z117). （2020Z117）
