中风与神经疾病杂志2025，Vol.42Issue(6)：523-528,6.DOI:10.19845/j.cnki.zfysjjbzz.2025.0099
急性颅内前循环大血管闭塞性缺血性脑卒中机械取栓术后出血转化的危险因素
Risk factors for hemorrhagic transformation after mechanical thrombectomy in acute ischemic stroke due to anterior circulation large vessel occlusion
摘要
Abstract
Objective To investigate the potential risk factors for hemorrhagic transformation(HT)after mechani-cal thrombectomy(MT)in patients with acute ischemic stroke due to anterior circulation large vessel occlusion(AIS-AC-LVO),and to provide a scientific evidence for reducing post-thrombectomy HT and improving the prognosis of patients.Methods A retrospective analysis was performed for the data of 605 patients with AIS-AC-LVO.The Logistic regression analysis was performed for related clinical data to identify independent predictive factors for HT after MT,with a signifi-cance threshold of P<0.05.Results A total of 605 patients were included in this study,among whom 207(34.2%)de-veloped HT after MT,while 398(65.8%)did not experience HT.The statistical analysis showed that multiple attempts of thrombectomy(OR=1.340,P=0.003),a prolonged time of operation(OR=1.005,P=0.024),a low ASPECTS score be-fore surgery(OR=0.798,P<0.001),postoperative mTICI≤2a(OR=6.329,P=0.032),a low platelet count before sur-gery(OR=0.995,P=0.008),and a high level of blood glucose before surgery(OR=1.088,P=0.009)were independent predictive factors for HT.Symptomatic intracranial hemorrhage(sICH)was observed in 68 patients(11.2%),and a his-tory of atrial fibrillation(OR=3.151,P=0.003),a low ASPECTS score before surgery(OR=0.868,P=0.007),a pro-longed time of operation(OR=1.009,P<0.001),poor collateral circulation(ASITN/SIR<2)(OR=2.307,P=0.035),a low platelet count before surgery(OR=0.993,P=0.012),a high level of D-dimer before surgery(OR=1.050,P=0.012),and a high level of blood glucose before surgery(OR=1.138,P=0.013)were independent predictive factors for sICH.Conclusion Multiple attempts of thrombectomy,a prolonged time of operation,a low ASPECTS score before sur-gery,postoperative mTICI≤2a,a low platelet count before surgery,and a high level of blood glucose before surgery are in-dependent predictive factors for HT.A history of atrial fibrillation,a low ASPECTS score before surgery,a prolonged time of operation,poor collateral circulation(ASITN/SIR<2),a low platelet count before surgery,a high level of D-dimer be-fore surgery,and a high level of blood glucose before surgery are independent predictive factors for sICH.Identifying such risk factors is crucial for reducing HT after MT and improving the efficacy of thrombectomy.关键词
急性大血管闭塞/缺血性脑卒中/机械取栓/出血转化Key words
Acute large vessel occlusion/Ischemic stroke/Mechanical thrombectomy/Hem-orrhagic transformation分类
医药卫生引用本文复制引用
张文玉,李中辰,昝旭,孙堂桂,郭洪阳,郝继恒,张利勇..急性颅内前循环大血管闭塞性缺血性脑卒中机械取栓术后出血转化的危险因素[J].中风与神经疾病杂志,2025,42(6):523-528,6.基金项目
山东省医药卫生科技项目(202304040921) （202304040921）
山东省医药卫生科技项目(202404041044) （202404041044）
