前循环急性缺血性脑卒中患者桥接治疗后预后不良的危险因素分析OA
Risk factors of poor prognosis in patients with anterior circulation acute ischemic stroke after bridging therapy and establishment of a predictive model
目的 探讨前循环急性缺血性脑卒中(AIS)患者桥接治疗后预后不良的危险因素.方法 回顾性选择2020年1月至2023年10月在杭州市第一人民医院接受桥接治疗的前循环AIS患者104例.根据改良Rankin量表(mRS)评分分为预后不良组(mRS＞2分)与预后良好组(mRS≤2分).收集两组患者的一般资料、实验室检查及桥接治疗手术相关指标.采用多因素logistic回归分析前循环AIS患者在桥接治疗后预后不良的独立危险因素.采用ROC曲线评估相关独立危险因素及因素联合预测前循环AIS患者桥接治疗后预后不良的效能.结果 预后不良组患者年龄大于预后良好组,空腹血糖水平、入院时美国国立卫生研究院卒中量表(NIHSS)评分及心房颤动、脑卒中相关性肺炎(SAP)、症状性颅内出血和颅内出血发生率高于预后良好组,差异均有统计学意义(均P＜0.05).两组患者的手术治疗时机及血管再通分级比较,差异均无统计学意义(均P＞0.05).SAP和入院时NIHSS评分均为前循环AIS患者桥接治疗后预后不良的独立危险因素(均P＜0.05).SAP和入院时NIHSS评分二者联合预测前循环AIS患者桥接治疗后预后不良的AUC高于二者单独预测.结论 前循环AIS患者桥接治疗后发生预后不良与SAP、入院时NIHSS评分相关,二者联合对前循环AIS患者桥接治疗后预后不良具有较高的预测效能.
Objective To explore the risk factors for poor prognosis in patients with anterior circulation acute ischemic stroke(AIS)after bridging therapy.Methods A total of 104 patients with anterior circulation AIS receiving bridging therapy at Hangzhou First People's Hospital from January 2020 to October 2023 were retrospectively enrolled.The patients were divided into poor prognosis group(mRS＞2 points)and good prognosis group(mRS ≤2 points)according to the modified Rankin Scale(mRS).General clinical data,laboratory examination results and surgical related indexes associated with bridging therapy were collected in the two groups.Multivariate logistic regression analysis was used to screen the independent risk factors of poor prognosis in anterior circulation AIS patients after bridging therapy.ROC curve analysis was performed to evaluate the predictive efficiency of these independent risk factors and their combination,for poor prognosis in patients with anterior circulation AIS after bridging therapy.Results The age of patients in the poor prognosis group was higher than that in the good prognosis group;elevated fasting blood glucose level,admission National Institutes of Health Stroke Scale(NIHSS)score,the incidences of atrial fibrillation,stroke-associated pneumonia(SAP),symptomatic intracranial hemorrhage(sICH)and intracranial hemorrhage were higher in the poor prognosis group,with statistically significant differences(all P＜0.05).There were no significant differences in surgical timing and vascular recanalization grading between the two groups(all P＞0.05).SAP and admission NIHSS score were independent risk factors for poor prognosis in anterior circulation AIS patients after bridging therapy(all P＜0.05).The AUC of the combined prediction of SAP combined with admission NIHSS score for the risk of poor prognosis in patients with anterior circulation AIS after bridging therapy was higher than that of SAP or admission NIHSS score alone.Conclusion Poor prognosis of anterior circulation AIS patients after bridging therapy is correlated with SAP and admission NIHSS score,and the combination of the two indicators has high predictive value for poor prognosis in anterior circulation AIS patients after bridging therapy.
魏婉;江翊茹;裘可凡;黄超;董晓巧;聂田;朱佳慧;何旭东;洪小琴
310022 西湖大学医学院附属杭州市第一人民医院城北院区(杭州市老年病医院)神经内科310022 西湖大学医学院附属杭州市第一人民医院城北院区(杭州市老年病医院)神经内科天台县人民医院神经内科310022 西湖大学医学院附属杭州市第一人民医院城北院区(杭州市老年病医院)神经内科310022 西湖大学医学院附属杭州市第一人民医院城北院区(杭州市老年病医院)神经外科310022 西湖大学医学院附属杭州市第一人民医院城北院区(杭州市老年病医院)神经外科310022 西湖大学医学院附属杭州市第一人民医院城北院区(杭州市老年病医院)神经内科310022 西湖大学医学院附属杭州市第一人民医院城北院区(杭州市老年病医院)神经内科310022 西湖大学医学院附属杭州市第一人民医院城北院区(杭州市老年病医院)神经内科
急性缺血性脑卒中前循环桥接治疗预后不良静脉溶栓血管内取栓术
Acute ischemic strokeAnterior circulationBridging therapyPoor prognosisIntravenous thrombolysisEndovascular thrombectomy
《浙江医学》 2026 (10)
1056-1061,6
杭州市卫生科技计划项目(A20210510)
评论