摘要
目的 探讨影响急性后循环缺血性卒中(PCIS)患者血管内治疗(EVT)的预后因素.方法 回顾性收集2020年1月至2023年8月在中国人民解放军联勤保障部队第九六○医院行EVT的71例急性PCIS患者的病例资料.术后90 d根据改良Rankin量表(mRS)评分分为预后良好组43例(mRS评分≤2分)和预后不良组28例(mRS评分＞2分),比较两组患者的年龄、性别、高血压及糖尿病等一般情况,以及血尿酸(BUA)、血肌酐(Scr)及血尿素氮(BUN)等临床资料.结果 共纳入71例发病24 h内入院接受EVT的急性PCIS患者,其中预后良好组43例,预后不良组28例.两组患者在性别、年龄、BUA、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、是否有高血压、糖尿病、冠心病、是否吸烟及饮酒等方面比较,差异无统计学意义(P＞0.05);单因素分析提示,预后不良组患者的Scr、BUN、术前美国国立卫生研究院卒中量表(NIHSS)评分及14 d NIHSS评分均高于预后良好组,差异有统计学意义(P＜0.05).经多元logistic回归显示,Scr(OR=3.414,P=0.041)、BUN(OR=4.265,P=0.035)是影响急性PCIS患者EVT治疗效果的独立危险因素.所有患者均未发生颅内出血及死亡.结论 急性PCIS患者EVT后能部分获益,Scr及BUN升高是影响急性PCIS患者EVT后预后不良的独立危险因素.
Abstract
Objective To investigate the factors influencing prognosis of endovascular treatment(EVT)in patients with acute posterior-circulation ischemic stroke(PCIS).Methods Clinical data was retrospectively collected from 71 patients with acute PCIS who underwent EVT at No.960 hospi-tal of PLA Joint Logistic Support Force Support Force from January 2020 to August 2023.Ninety days after surgery,the patients were classified into two groups based on the modified Rankin Scale(mRS)score:good prognosis group(43 patients,mRS score ≤ 2)and worse prognosis group(28 patients,mRS score＞2).General data and clinical data were compared between two groups,inclu-ding age,gender,hypertension,diabetes,blood uric acid(BUA),serum creatinine(Scr)and blood urea nitrogen(BUN),etc.Results A total of 71 patients with acute PCIS admitted to the hospital for EVT within 24 hours of onset were included.Among which,there were 43 patients in good prognosis group,28 patients in worse prognosis group.There were no significant differences in gender,age,BUA,total cholesterol(TC),triglyceride(TG),Low-density lipoprotein cholesterol(LDL-C),hy-pertension,diabetes,coronary heart disease,smoking and drinking between two groups(P＞0.05).Univariate analysis showed that Scr,BUN,preoperative National Institutes of Health Stroke Scale(NIHSS)scores,and NIHSS scores on postoperative day 14 were higher in worse prognosis group than those in good prognosis group(P＜0.05).Multiple logistic regression analysis revealed that Scr(OR=3.414,P=0.041)and BUN(OR=4.265,P=0.035)were independent risk factors affecting the therapeutic efficacy of EVT in the patients with acute PCIS.All patients did not experience in-tracranial hemorrhage or death.Conclusion The patients with acute PCIS can partially benefit from EVT.Elevated Scr and BUN are independent risk factors affecting poor prognosis after EVT in the patients with acute PCIS.
NETL
NSTL
维普
万方数据