急性基底动脉闭塞性脑梗死再灌注治疗的预后因素

Prognostic Factors in Patients with Acute Basilar Artery Occlusive Cerebral Infarction

目的探讨临床指标对后循环急性基底动脉闭塞患者再灌注治疗后临床结局的预测价值。方法选取安徽医科大学附属宿州医院2018年3月~2019年12月接受再灌注治疗的27例急性基底动脉闭塞导致的急性脑梗死患者作为研究对象。应用弥散加权成像(DWI)评估患者的后循环阿尔伯塔脑卒中计划早期诊断评分(PC-ASPECTS)和采用脑部数字减影血管造影进行后循环侧支评分(PC-CS)。患者均给予静脉溶栓及动脉取栓等再灌注治疗,90 d时使用改良Rankin量表评分(mRS)评估功能结局。按照mRS评分分为预后良好组(mRS为0〜3分)11例和预后不良组(mRS>3分)16例,比较两组的预后因素。结果预后良好组年龄小于预后不良组,入院时美国国立卫生研究院卒中量表(NIHSS)评分低于预后不良组,PC-ASPECTS,PC-CS高于预后不良组,差异均有统计学意义(P<0.05)。结论急性基底动脉闭塞患者的预后与年龄、入院时NIHSS评分、PC-ASPECTS评分、PC-CS评分等因素有关,这些指标有助于评估病情、判断预后。

Objective To investigate the predictive value of clinical indicators on the clinical outcome after reperfusion therapy in patients with posterior circulation acute basilar artery occlusion.Methods Twenty-seven patients with acute cerebral infarction due to acute basilar artery occlusion who received reperfusion therapy from March 2018 to December 2019 in Suzhou Hospital Affiliated to Anhui Medical University were selected as the research subjects.The posterior circulation Alberta stroke program early CT score(PC-ASPECTS)was assessed using diffusion-weighted imaging(DWI),and posterior circulation collateral score(PC-CS)was assessed using digital subtraction angiography of the head.All patients received reperfusion therapy such as intravenous thrombolysis and arterial thrombectomy.The modified Rankin scale(mRS)was used to evaluate the functional outcome on day 90 after treatment.According to mRS score,11 cases were assigned to a good prognosis group(mRS 0-3 points),and 16 cases to a poor prognosis group(mRS>3 points).The prognostic factors of the two groups were compared.Results In good prognosis group,the age was younger,score of national institute of health stroke scale(NIHSS)at admission was lower,and the scores of PC-ASPECTS and PC-CS were higher than those in poor prognosis group with statistical significance(P<0.05).Conclusion The prognosis of patients with acute basilar artery occlusion is related to age,NIHSS score at admission,and the scores of PC-ASPECTS and PC-CS,which are helpful to evaluate the patients condition and the prognosis.