Chinese Journal of Contemporary Neurology and Neurosurgery ›› 2020, Vol. 20 ›› Issue (5): 407-412. doi: 10.3969/j.issn.1672-6731.2020.05.007

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Analysis of prognostic factors of mechanical thrombectomy in patients with acute ischemic stroke with large vessel occlusion

LIU Yong-chang, ZHENG Ming-ming, LI Yan, XIE Song-wang, WANG Jun-yong, LIU Qing-ran   

  1. Department of Neurovascular Intervention, Cangzhou Central Hospital, Cangzhou 061000, Hebei, China
  • Received:2020-05-08 Online:2020-05-25 Published:2020-05-19

急性大血管闭塞性缺血性卒中患者机械取栓术后预后影响因素分析

刘永昌, 郑明明, 李严, 谢松旺, 王俊勇, 刘庆冉   

  1. 061000 河北省沧州市中心医院神经血管介入科
  • 通讯作者: 刘永昌,Email:lyc0749@163.com

Abstract:

Objective To screen the related factors of prognosis after mechanical thrombectomy in patients with acute ischemic stroke with large vessel occlusion (AIS-LVO). Methods From January 2018 to July 2019, a total of 117 patients with AIS-LVO underwent intravascular mechanical thrombectomy (including stent thrombectomy, catheter aspiration, stent thrombectomy combined with catheter aspiration). Univariate and multivariate Logistic regression analysis were used to screen the risk factors for poor prognosis. Results Logistic regression analysis showed that the elderly (OR=1.062, 95%CI:1.013-1.113; P=0.012), the previous diabetes (OR=3.074, 95% CI:1.023-9.240; P=0.045), the high NIHSS score at admission (OR=1.143, 95% CI:1.043-1.252; P=0.004), the responsible blood vessel was vertebrobasilar artery (OR=11.151, 95% CI:2.877-43.079; P=0.000) were the risk factors of poor prognosis after mechanical thrombectomy for AIS-LVO. Conclusions Elderly, the previous diabetes, high NIHSS score and posterior circulation infarction are associated with poor prognosis in patients with AIS-LVO after intravascular mechanical thrombectomy.

Key words: Arterial occlusive diseases, Vertebrobasilar insufficiency, Carotid artery, internal, Thrombectomy, Prognosis, Risk factors, Logistic models

摘要:

目的 筛查急性大血管闭塞性缺血性卒中血管内机械取栓术后预后相关影响因素。方法 2018年1月至2019年7月共117例急性大血管闭塞性缺血性卒中患者行血管内机械取栓术(包括支架取栓术、抽吸取栓术、支架取栓术联合抽吸取栓术),单因素和多因素Logistic回归分析筛查术后预后不良危险因素。结果 Logistic回归分析显示,高龄(OR=1.062,95% CI:1.013~1.113;P=0.012)、既往糖尿病(OR=3.074,95% CI:1.023~9.240;P=0.045)、入院时高NIHSS评分(OR=1.143,95% CI:1.043~1.252;P=0.004)、责任血管为椎-基底动脉(OR=11.151,95% CI:2.877~43.079;P=0.000)是急性大血管闭塞性缺血性卒中血管内机械取栓术后预后不良的危险因素。结论 高龄,既往糖尿病、入院时高NIHSS评分、后循环缺血性卒中的急性大血管闭塞性缺血性卒中患者血管内机械取栓术后预后不良。

关键词: 动脉闭塞性疾病, 椎底动脉供血不足, 颈内动脉, 血栓切除术, 预后, 危险因素, Logistic 模型