急性前循环缺血性卒中血管内治疗的预后因素分析

Prognosis factors analysising of acute anterior circulation ischemic stroke endovascular treatment

目的分析急性前循环缺血性卒中行血管内治疗后的预后因素。方法本研究为前瞻性队列研究,选取2019年1月至2020年5月常德市第一人民医院前循环缺血性卒中行血管内治疗的患者90例,根据患者术后90 d改良的Rankin量表(mRS)评分分为功能改善组(mRS评分0~2分)和功能不良组(mRS评分3~6分),应用单因素分析及多因素分析获得患者预后的影响因素并剔除混杂因素,再行曲线拟合分析预后因素与术后90 d mRS评分的关系。结果共有77例患者完成随访,其中功能改善组29例(37.6%),功能不良组48例(62.3%),单因素分析显示,两组年龄、房颤病史、侧枝循环代偿等级、淋巴细胞计数、血红蛋白、低密度脂蛋白、收缩压、C反应蛋白、D-二聚体、NIHSS评分比较差异有统计学意义(P<0.05);多因素分析显示,两组C反应蛋白、侧枝循环代偿等级比较差异有统计学意义(P<0.05)。结论急性缺血性卒中行血管内治疗后患者的预后可能与C反应蛋白、侧枝循环代偿等级相关。

Objective To analysis of influencing factors of acute anterior circulation ischemic stroke endovascular treatment.Methods This study was designed as a prospective cohort study,90 patients with acute anterior circulation ischemic stroke hospitalized in the Department of Neurology of the First People’ s Hospital of Changde City from January 2019 to May 2020 were selected,according to the modified Rankin Scale(mRS)score at 90 days after operation,the patients were divided into functional improvement group(mRS score 0-2) and dysfunction group(mRS score 3-6).Univariate analysis and multivariate analysis were used to obtain the results.Influencing factors of patient prognosis and excluding confounding factors,curve fitting was performed to analyze the relationship between prognostic factors and mRS score at 90 days after operation.Results A total of 77 patients completed follow-up,including 29 patients(37.6%) in the functional improvement group and 48 patients(62.3%) in the dysfunction group.Univariate analysis showed that there were significant differences in age,history of atrial fibrillation,collateral circulation compensation level,lymphocyte count,hemoglobin,low-density lipoprotein,systolic blood pressure,C-reactive protein,D-dimer,and NIHSS score between the two groups(P<0.05).Multivariate analysis showed that there were statistically significant differences in the levels of C-reactive protein and collateral circulation compensation between the two groups(P<0.05).Conclusion The Prognosis of Acute anterior circulation ischemic stroke Endovascular treatment may be Associated with c-reactive protein,collateral circulation grade.