临床神经病学杂志2026，Vol.39Issue(1)：11-15,5.
急性大脑中动脉闭塞患者机械取栓再通后出血转化危险因素分析
Analysis of risk factors for hemorrhagic transformation after recanalization of mechanical thrombectomy in patients with acute middle cerebral artery occlusion
摘要
Abstract
Objective To investigate the risk factors for hemorrhagic transformation(HT)after recanalization of mechanical thrombectomy in patients with acute middle cerebral artery occlusion.Methods According to postoperative HT status,104 patients with acute middle cerebral artery occlusion who underwent mechanical thrombectomy and recanalization were divided into HT group(29 cases)and non-HT group(75 cases).General clinical data were collected,and factors with statistical significance in univariate analysis were subjected to binary Logistic regression analysis,with ROC curves drawn.Result Compared with those in non-HT group,the ratio of diabete,emergency blood glucose level and preoperative NIHSS score in HT group were significantly increased,the ratio of drinking history was significantly decreased,and the number of thrombectomies was significantly increased(all P<0.05).Logistic regression analysis showed that emergency blood glucose,preoperative NIHSS score and number of thrombectomies were independent risk factors for HT after mechanical thrombectomy for acute middle cerebral artery occlusion(OR=1.264,95%CI:1.019-1.569,P=0.033;OR=1.201,95%CI:1.066-1.355,P=0.003;OR=2.698,95%CI:1.232-5.910,P=0.013).The area under curve(AUC)of the ROC of the combined prediction model for emergency blood glucose level,preoperative NIHSS score and number of thrombectomies was 0.794(95%CI:0.692-0.896,P<0.001),Youden index was 0.514,the sensitivity was 0.621,and the specificity was 0.893.The predictive value of the combined prediction model was higher than those of emergency blood glucose(AUC=0.622,P=0.055),preoperative NIHSS score(AUC=0.689,P=0.003)and number of thrombectomies(AUC=0.601,P=0.112).Conclusion Emergency blood glucose level,preoperative NIHSS score,and the number of thrombectomies are independent risk factors for HT after mechanical thrombectomy in acute middle cerebral artery occlusion,and have predictive value for HT after thrombectomy.关键词
急性大脑中动脉闭塞/急性缺血性脑卒中/出血转化/机械取栓Key words
acute middle cerebral artery occlusion/acute ischemic stroke/hemorrhagic transformation/mechanical thrombectomy分类
医药卫生引用本文复制引用
褚忠海,陈季南,杨倩,陈靖..急性大脑中动脉闭塞患者机械取栓再通后出血转化危险因素分析[J].临床神经病学杂志,2026,39(1):11-15,5.基金项目
南京医科大学康达学院2023 年度科研发展基金(KD2023KYJJ257) （KD2023KYJJ257）
