机械取栓治疗急性基底动脉闭塞患者预后的影响因素研究

Influencing Factors of Prognosis of Patients with ABAO Treated by Mechanical Thrombectomy

背景急性基底动脉闭塞(ABAO)是缺血性脑卒中的一种,其起病急、预后差,因此如何根据相关指标判断预后情况显得极为重要。目的探讨机械取栓治疗ABAO患者预后的影响因素。方法选取2018年1月—2019年1月南阳市中心医院接受机械取栓治疗的ABAO患者53例,根据90 d改良Rankin量表(mRS)评分分为预后良好组(n=28)及预后不良组(n=25)。比较两组患者一般资料,发病至穿刺时间,手术时间,入院、治疗24 h、治疗30 d美国国立卫生研究院卒中量表(NIHSS)评分,血栓长度,血栓位置,血流再通分级,侧支循环分级,症状性颅内出血及死亡情况。ABAO患者的预后影响因素分析采用多因素Logistic回归分析。结果预后良好组患者手术时间、血栓长度短于预后不良组,入院、治疗24 h、治疗30 d NIHSS评分低于预后不良组,血流再通分级、侧支循环分级优于预后不良组,病死率低于预后不良组(P<0.05)。行多因素Logistic回归分析结果显示,治疗24 h NIHSS评分〔OR=22.294,95%CI(2.989,166.275)〕和侧支循环分级〔OR=0.010,95%CI(0.001,0.151)〕是机械取栓治疗ABAO患者预后的影响因素(P<0.05)。结论治疗24 h NIHSS评分、侧支循环分级是机械取栓治疗ABAO患者预后的影响因素。

Background Acute basilar artery occlusion(ABAO)as a type of ischemic stroke,which has poor onset and rapid prognosis.Therefore,it is very important to judge the prognosis according to the relevant indicators.Objective To explore the influencing factors of prognosis of patients with ABAO treated by mechanical thrombectomy.Methods Fifty-three ABAO patients who received mechanical thrombectomy from Nanyang Central Hospital from January 2018 to January 2019 were selected,and divided into good prognosis group(n=28)and poor prognosis group(n=25)according to the 90 d mRS score.Comparison of general information,time from onset to puncture,operation time,NIHSS score of admission,24 hours after treatment and 30 days after treatment,thrombus length,thrombus location,grading of blood flow recanalization,collateral circulation,symptomatic intracranial hemorrhage and death.Multivariate Logistic analysis was used to analyze influencing factors of prognosis of patients with ABAO treated by mechanical thrombectomy.Results Operation time and thrombus length in good prognosis group were statistically significantly shorter than those in poor prognosis group(P<0.05),NIHSS score of admission,24 hours and 30 days after treatment in good prognosis group was statistically significantly lower than that in poor prognosis group(P<0.05),grade of blood flow recanalization and collateral circulation in good prognosis group were statistically significantly better than those in poor prognosis group(P<0.05),mortality in good prognosis group was statistically significantly lower than that in poor prognosis group(P<0.05).Multivariate Logistic analysis results showed that,NIHSS score〔OR=22.294,95%CI(2.989,166.275)〕,and grade of collateral circulation〔OR=0.010,95%CI(0.001,0.151)〕were influencing factors of prognosis of patients with ABAO treated by mechanical thrombectomy(P<0.05).Conclusion 24 hours after treatment NIHSS score and collateral circulation are independent influential factors prognostic factor of ABAO patients treated by mechanical thrombectomy.