急性缺血性脑卒中患者机械取栓的预后因素分析

目的 机械取栓为血管内治疗的新方案,在急性缺血性脑卒中的治疗中具有良好的效果。本文探讨急性缺血性脑卒中患者机械取栓术后影响临床预后的因素。 方法 选取2017年1月—2018年12月中国科学技术大学附属第一医院神经内科因急性缺血性脑卒中行机械取栓的患者87例,预后的评价通过术后3个月的改良Rankin量表(mRS)评分来确定,mRS≤3分认为预后良好(44例),mRS 4~6分认为预后不良(43例)。采用多因素logistic回归分析探究影响临床预后的因素。 结果 预后良好与预后不良患者在年龄、术前美国国立卫生研究院卒中量表(NIHSS)评分、术后24 h NIHSS评分方面差异有统计学意义(均P<0.05)。多因素logistic回归分析显示,术前NIHSS评分与不良预后有关(OR=1.820,95%CI:1.19~2.77,P=0.005),术后24 h NIHSS评分以及年龄与不良预后显著相关(术后24 h NIHSS评分:OR=2.006,95%CI:1.30~3.10,P=0.002;年龄:OR=1.102,95%CI:1.04~1.17,P=0.001)。 结论 年龄、NHISS评分与急性缺血性脑卒中患者机械取栓的预后存在显著性关系,年龄和NIHSS有助于评估患者的预后情况。 

Analysis of prognostic factors of mechanical thrombectomy in acute ischemic stroke patients

Objective Mechanical thrombectomy is a new method of endovascular therapy, with good effect in the treatment of acute ischemic stroke. To explore the clinical prognostic factors of acute ischemic stroke patients after mechanical thrombectomy. Methods Total 87 patients with mechanical thrombectomy in our hospital from January 2017 to December 2018 were included in our research. The modified Rankin Scale(mRS) scores was regarded as prognosis assessment at 90 days. The mRS scores ≤ 3 points were considered good prognosis(44 cases), mRS scores 4-6 points were considered poor prognosis(43 cases). Multivariate Logistic regression was used to investigate the prognosis. Results There were significant differences in age and National Institutes of Health Stroke Scale(NIHSS) scores(both baseline and 24 h post-operative) of the patients between the good and the poor prognosis group(all P<0.05). Multivariate Logistic regression analysis showed that the age, baseline and 24 h post-operative NIHSS scores were risk factors for poor prognosis of mechanical thrombectomy(Baseline NIHSS score: OR=1.820, 95% CI=1.19-2.77, P=0.005; Post-operative NIHSS score: OR=2.006, 95% CI=1.30-3.10, P=0.002; Age: OR=1.102, 95% CI=1.04-1.17, P=0.001). Conclusion NIHSS scores and age are independent risk factors for prognosis of acute ischemic stroke patients treated with mechanical thrombectomy.