中风与神经疾病杂志2024，Vol.41Issue(8)：729-734,6.DOI:10.19845/j.cnki.zfysjjbzz.2024.0140
急性前循环缺血性卒中机械取栓术后快速神经功能改善的预测因素
Predictors of rapid neurological improvement after mechanical thrombectomy in acute anterior circulation isch-emic stroke
摘要
Abstract
Objective To investigate the factors influencing rapid neurological improvement(RNI)after mechani-cal thrombectomy(MT)in patients with acute anterior circulation ischemic stroke(AACIS),and to construct a predictive scoring model for RNI.Methods A retrospective study was conducted on 312 AAIS patients treated with MT at the South-west Hospital and the Zigong Third People's Hospital from January 2017 to October 2021.Univariate analysis and multi-variate logistic regression analysis were performed to identify the independent factors influencing RNI.A scoring model for RNI prediction was established by assigning scores to significant variables in multivariate analysis.The prediction value was evalu-ated using the receiver operating characteristic(ROC)curve.Results Among the 312 AACIS patients,159(50.96%)dem-onstrated RNI.Multivariate logistic regression analysis showed that history of diabetes mellitus[odds ratio(OR)=0.518;95%confidence interval(CI)0.290-0.926;P=0.027]and Van Swieten score(3-4 points)(OR=0.537;95%CI 0.294-0.981;P=0.043)were independent risk factors for RNI in AACIS patients after MT.However,mTICI(grade 2b or 3)was an inde-pendent protective factor for RNI in patients with AACIS(OR=3.912;95%CI 1.706-8.982;P=0.001).The area under the ROC curve of the predictive scoring model was 0.628(95%CI 0.565-0.690;P<0.001).The optimal cut-off value was 3 points,the sensitivity was 68.39%,and the specificity was 52.98%.Conclusion The predictive scoring model consisting of history of diabetes mellitus,preoperative Van Swieten score,and postoperative mTICI grade is valuable in predicting RNI in patients with AACIS after MT.关键词
急性前循环缺血性卒中/机械取栓术/快速神经功能改善/预测评分模型Key words
Acute anterior circulation ischemic stroke/Mechanical thrombectomy/Rapid neurological im-provement/Predictive scoring model分类
临床医学引用本文复制引用
巨文盈,高旸,何雨轩,左朦,吴敏..急性前循环缺血性卒中机械取栓术后快速神经功能改善的预测因素[J].中风与神经疾病杂志,2024,41(8):729-734,6.基金项目
国家卫生健康委员会脑卒中高危人群筛查和干预项目(Z135080000022) （Z135080000022）
