大核心梗死的急性缺血性卒中血管内治疗疗效观察与影响因素分析

马雪; 易倩; 赵秋菊; 雷利; 张猛

doi:10.16016/j.1000-5404.202106128

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大核心梗死的急性缺血性卒中血管内治疗疗效观察与影响因素分析

临床医学 | 更新时间：2026-01-09

- 大核心梗死的急性缺血性卒中血管内治疗疗效观察与影响因素分析
- Efficacy of endovascular treatment for acute ischemic stroke with large core infarction and its influencing factors
- 第三军医大学学报 2021年43卷第24期页码：2677-2682
- 作者机构：
  
  400042 重庆，陆军军医大学(第三军医大学)大坪医院神经内科
- 作者简介：
  
  [ 张猛，E-mail: zhangmeng@tmmu.edu.cn ZHANG Meng, E-mail: zhangmeng@tmmu.edu.cn
- 基金信息：
  
  重庆市卫生适宜技术推广项目(2018jstg013);陆军特色医学中心创新能力培养计划(2019CXHLC013)
- DOI：10.16016/j.1000-5404.202106128
  中图分类号： R181.32;R741.05;R743.31
- 收稿：2021-06-17，
  
  修回：2021-08-11，
  
  纸质出版：2021-12-30
- 稿件说明：
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马雪, 易倩, 赵秋菊, 等. 大核心梗死的急性缺血性卒中血管内治疗疗效观察与影响因素分析[J]. 第三军医大学学报, 2021,43(24):2677-2682.

Xue MA, Qian YI, Qiuju ZHAO, et al. Efficacy of endovascular treatment for acute ischemic stroke with large core infarction and its influencing factors[J]. Journal of Third Military Medical University, 2021, 43(24): 2677-2682.
马雪, 易倩, 赵秋菊, 等. 大核心梗死的急性缺血性卒中血管内治疗疗效观察与影响因素分析[J]. 第三军医大学学报, 2021,43(24):2677-2682. DOI： 10.16016/j.1000-5404.202106128.

Xue MA, Qian YI, Qiuju ZHAO, et al. Efficacy of endovascular treatment for acute ischemic stroke with large core infarction and its influencing factors[J]. Journal of Third Military Medical University, 2021, 43(24): 2677-2682. DOI： 10.16016/j.1000-5404.202106128.

摘要

目的

探讨伴有大核心梗死的前循环大血管闭塞急性缺血性卒中(acute ischemic stroke with large vessel occlusion，AIS-LVO)患者早期血管内治疗(endovascular treatment

EVT))的效果与影响因素。

方法

回顾性分析2020年1-11月在我院住院行EVT的31例伴有大核心梗死体积的AIS-LVO患者病例资料。收集患者术前美国国立卫生研究院卒中量表评分(National Institute of Health stroke Scale，NIHSS)、Alberta卒中项目早期CT评分(Alberta stroke program early CT score

ASPRCTS)与侧支循环评分；记录术后血管再通、抗血小板药物治疗情况。根据术后90 d改良Rankin评分量表(modified Rankin scale，mRS)将患者分为预后良好组和预后不良组，采用Logistic回归分析AIS-LVO患者预后的相关因子。

结果

术后血管再通25例(再通率80.6%)，术后90 d良好预后率为32.2%，颅内出血(intracranial hemorrhage，ICH)发生率为41.9%，其中症状性颅内出血(symptomatic intracranial hemorrhage，sICH)发生率为12.9%，病死率12.9%。与预后不良组(mRS＞2分)相比，预后良好组(mRS≤2分)患者年龄更小(

=0.804，95%

=0.657~0.983，

=0.034)。

结论

大核心梗死的AIS-LVO患者EVT后，能部分获益，其中患者年龄是影响预后的重要因素。

Abstract

Objective

To investigate the efficacy and influencing factors of early endovascular treatment (EVT) in the patients encountering acute ischemic stroke with large vessel occlusion (AIS-LVO) in the anterior circulation accompanying large core infarction.

Methods

The clinical data of 31 patients diagnosed as AIS-LVO accompanying large core infarction who underwent EVT in our hospital from January to November 2020 were collected and retrospectively analyzed. Basic information such as age and gender

as well as National Institutes of Health Stroke Scale (NIHSS) score

Alberta Stroke Project Early Computed Tomography (ASPECTS) score

and collateral circulation scores were collected. Postoperative revascularization condition and antiplatelet medication therapy were also recorded. The patients were subsequently divided into good and poor prognosis groups according to the modified Rankin scale (mRS) in 90 d after surgery. The related predictors for good prognosis here explored by multivariate logistic regression analysis.

Results

Twenty-five cases (80.6%) obtained postoperative revascularization; the incidence of intracranial hemorrhage (ICH) was 41.9%

with 12.9% being symptomatic intracranial hemorrhage (sICH); the good prognosis rate was 32.2% at 90th day after surgery

and the mortality rate was 12.9%. The patients in the good prognosis group had younger age than those in the poor prognosis group (mRS

2) (

=0.804

95%

=0.657~0.983

=0.034).

Conclusion

The patients of AIS-LVO accompanying large core infarction can partially benefit from endovascular treatment

and the age of patients is an important factor affecting prognosis.

关键词

Keywords

references

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