Safety and efficacy of early endovascular therapy combined with butylphthalide for acute basilar artery occlusion: a multicenter, prospective cohort study

Shuai LIU; Wenjie ZI; Zhongming QIU; Fengli LI; Hansheng LIU; Junjie YUAN; Weidong LUO; Hongfei SANG; Feixue YUE; Rongzong LI; Wang CHEN; Kuihua WANG; Jun SUN; Zhangbao GUO; Wei XU; Qingwu YANG; Zili GONG

doi:10.16016/j.1000-5404.202008058

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Safety and efficacy of early endovascular therapy combined with butylphthalide for acute basilar artery occlusion: a multicenter, prospective cohort study

Neurosciences | 更新时间：2026-01-09

- Safety and efficacy of early endovascular therapy combined with butylphthalide for acute basilar artery occlusion: a multicenter, prospective cohort study
- Journal of Third Military Medical University Vol. 43, Issue 2, Pages: 124-130(2021)
- 作者机构：
  
  1.400037 重庆, 陆军军医大学(第三军医大学)第二附属医院神经内科
  2.310006 杭州，杭州市第一人民医院神经内科
  3.130000 长春，吉林大学白求恩第一医院神经内科
  4.541002 广西桂林，中国人民解放军联勤保障部队第九二四医院神经内科
  5.276000 山东临沂，临沂市人民医院神经内科
  6.350025 福州，中国人民解放军联勤保障部队第九○○医院神经内科
  7.473009 河南南阳，南阳市中心医院神经内科
  8.430022 武汉，武汉市第一医院神经内科
  9.410004 长沙，长沙市中心医院神经内科
- 作者简介：
- 基金信息：
  
  the National Science Foundation for Distinguished Young Scholars of China(81525008);the Talent Training Program in Clinical Medical Scientific Research of Army Medical University(2018XLC2013);the Key R&D and Promotion Project of Henan Province(192102310349)
- DOI：10.16016/j.1000-5404.202008058
  CLC： R743.3;R969.4;R972
- Received：07 August 2020，
  
  Revised：2020-08-26，
  
  Published：30 January 2021
- 稿件说明：
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Shuai LIU, Wenjie ZI, Zhongming QIU, et al. Safety and efficacy of early endovascular therapy combined with butylphthalide for acute basilar artery occlusion: a multicenter, prospective cohort study[J]. Journal of Third Military Medical University, 2021, 43(2): 124-130.
DOI：

Shuai LIU, Wenjie ZI, Zhongming QIU, et al. Safety and efficacy of early endovascular therapy combined with butylphthalide for acute basilar artery occlusion: a multicenter, prospective cohort study[J]. Journal of Third Military Medical University, 2021, 43(2): 124-130. DOI： 10.16016/j.1000-5404.202008058.

摘要

目的

探讨急性基底动脉闭塞患者早期血管内治疗联用丁苯酞的有效性及安全性。

方法

连续性纳入2014年1月至2019年5月在陆军军医大学第二附属医院及46家分中心的急性基底动脉闭塞早期接受血管内治疗患者，依据是否使用丁苯酞药物治疗，将其分为丁苯酞组和对照组，比较90 d良好功能预后发生率、48 h内症状性颅内出血(symptomatic intracranial hemorrhage

sICH)和90 d病死率。采用二元Logistic回归探讨丁苯酞与90 d功能预后、sICH发生率及90 d病死率的相关性，校正因素包括年龄、血压、发病到穿刺时间、mTICI血流分级、糖尿病、基线NIHSS评分、后循环Alberta卒中项目早期CT评分、闭塞部位等混杂因素。

结果

最终共纳入患者645例，丁苯酞组232例，对照组413例。丁苯酞组90 d良好功能预后比例显著高于对照组[39.2%(91/232)

28.1%(116/413)；χ

=8.454，

=0.005

]

；丁苯酞组患者sICH发生率明显低于对照组[1.7%(4/232)

10.2%(41/403)，χ

=15.965，

0.001

]

；丁苯酞组90 d病死率显著低于对照组[34.1%(79/232)

52.8%(218/413)，χ

=20.983，

0.001

]

。使用丁苯酞治疗是90 d良好功能预后(

: 1.646，95%

1.091~2.483，

=0.018)、降低sICH发生率(

: 0.164，95%

：0.056~0.475，

=0.001)及90 d病死率(

: 0.424，95%

: 0.278~0.647，

0.001)的独立保护因素。

结论

早期血管内治疗联用丁苯酞可显著改善急性基底动脉闭塞患者的90 d功能预后，降低sICH风险及病死率。

Abstract

Objective

To investigate the efficacy and safety of early endovascular therapy (EVT) combined with butylphthalide (NBP) in the patients with acute basilar artery occlusion (BAO).

Methods

From January 2014 to May 2019

645 acute BAO patients (from the Second Affiliated Hospital of Army Medical University and other 46 comprehensive stroke centers in China) who underwent EVT were enrolled into this study. According to receiving NBP treatment or not

the patients were divided into simple EVT group (control group

=413) and EVT+NBP group (NBP group

=232). Safety and efficacy were evaluated and compared between the 2 groups

with symptomatic intracerebral hemorrhage (sICH) within 48 h and 90-day all cause mortality as evaluation criteria for safety

and the modified Rankin Scale (mRS) score and the modified Thrombolysis in Cerebral Infarction (mTICI) for efficacy. Binary Logistic regression was used for multi-factor analysis

with calibration factors of age

blood pressure

time from onset to puncture

mTICI grade

diabetes mellitus

baseline NIHSS score

pc-ASPECTS score

ASITN/SIR grade and occlusion sites

etc.

Results

At 90 d after treatment

the NBP group had a higher rate of mRS low score (≤3) than the control g

roup [39.2% (91/232)

28.1% (116/413)

Chi

-square=8.454

=0.005

]

indicating better functional prognosis. The incidence of sICH [1.7% (4/232)

10.2% (41/403)

Chi

-square=15.965

0.001

]

and 90-day mortality [34.1% (79/232)

52.8% (218/413)

Chi

-square=20.983

0.001

]

were both significantly lower in the NBP group when compared to the control group. Logistic regression analysis indicated that NBP was an independent protective factor for good functional prognosis at 90 d (

=1.646

95%

: 1.091~2.483

=0.018)

reduced incidence of sICH (

=0.164

95%

: 0.056~0.475

=0.001) and lower mortality at 90 d (

=0.424

95%

: 0.278~0.647

0.001).

Conclusion

Early EVT combined with NBP can significantly improve the 90-day functional prognosis

and reduce the sICH risk and mortality in the acute BAO patients.

关键词

Keywords

references

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