烟雾病患者颅内联合血运重建术后神经功能恢复的影响因素分析

Influencing factors of neurological function recovery after combined intracranial revascularization in patients with moyamoya disease

目的探讨烟雾病患者行颅内联合血运重建术后神经功能恢复的影响因素。方法采用便利抽样法,于2018年1月—2019年1月选取河南省人民医院收治的122例烟雾病患者为研究对象,将改良Rankin量表(mRS)评分<3分的患者分为神经功能预后良好组(n=86),将mRS评分≥3分的患者分为神经功能预后不良组(n=36),比较两组患者相关临床资料,采用二项Logistic回归分析探索烟雾病患者行颅内联合血运重建术后神经功能预后不良的危险因素。结果二项Logistic回归分析结果显示,格拉斯哥昏迷(GCS)评分、术前频繁短暂性脑缺血发作、Suzuki分级≥3、高血压病及收缩压高是烟雾病患者行颅内联合血运重建术后发生神经功能预后不良的独立危险因素(P<0.05)。结论烟雾病患者行颅内联合血运重建术后发生神经功能预后不良的影响因素包括GCS评分较低、术前频繁短暂性脑缺血发作、收缩压高、Suzuki分级≥3及高血压病,采取针对性措施可能会降低烟雾病患者神经功能预后不良的发生风险。

Objective To explore influencing factors of neurological function recovery after combined intracranial revascularization in patients with moyamoya disease.Methods Using the convenient sampling method,a total of 122 patients with moyamoya disease who were admitted to Henan Provincial People's Hospital from January 2018 to January 2019 were selected as the research objects.Patients with Modified Rankin Scale(mRS)score less than 3 points were set as the good neurological prognosis group(n=86),and patients with mRS score greater than or equal to 3 points were set as the poor neurological prognosis group(n=36).The clinical data of patients were compared between the two groups.Binary Logistic regression analysis was used to explore risk factors for poor prognosis of neurological function in patients with moyamoya disease after combined intracranial revascularization.Results Binary Logistic regression analysis showed that Glasgow Coma Score(GCS),frequent transient ischemic attacks before surgery,Suzuki grade greater than or equal to 3,hypertension,and high systolic high blood pressure were independent risk factors for poor prognosis of neurologic function in patients with moyamoya disease after combined intracranial revascularization(P<0.05).Conclusions Influencing factors for poor neurological outcome after combined intracranial revascularization in patients with moyamoya disease include low GCS score,frequent transient ischemic attacks before surgery,high systolic blood pressure,Suzuki grade greater than or equal to 3 and hypertension.Taking targeted measures may reduce risk of poor neurological prognosis in patients with moyamoya disease.