急性缺血性脑梗死机械取栓术后24 h内DRAGON评分联合TIBI分级对预后的预测价值

Predictive Value of DRAGON Score Combined with TIBI Grading within 24 hours after Mechanical Thrombectomy for Prognosis of Acute Ischemic Cerebral Infarction

【目的】探讨急性缺血性脑梗死机械取栓术后24 h内DRAGON评分联合血流灌注分级(TIBI)对预后的预测价值。【方法】对本院收治的98例行机械取栓术的急性缺血性脑梗死患者术后24 h的DRAGON评分及TIBI分级进行评估,并根据患者术后1周内预后情况将其分为预后不佳组和预后良好组。以Logistic多因素回归分析影响术后1周内预后不佳的相关因素,以受试者工作特征(ROC)曲线分析DRAGON评分、TIBI分级单独及联合对术后1周内再发脑梗死的预测价值。【结果】98例患者中,58例术后1周内预后不佳(预后不佳组),占比59.18%;40例预后良好(预后良好组),占比40.82%。预后不佳组基线CTA侧支代偿评分差、TIBI分级0~3级所占比例及DRAGON评分均高于预后良好组(P<0.05);Logistic多因素回归分析结果显示,基线CTA侧支代偿评分差、TIBI分级0~3级所占比例及DRAGON评分高均为术后1周内预后不佳的危险因素(P<0.05);ROC曲线分析显示,TIBI分级、DRAGON评分及两者联合对术后1周内预后不佳的ROC预测的曲线下面积(AUC)分别为0.769、0.785、0.839,且TIBI分级、DRAGON评分单一对患者术后1周内预后不佳的预测效能低于两者联合(P<0.05)。【结论】TIBI分级0~3级及DRAGON评分高均为急性缺血性脑梗死行机械取栓术患者术后1周内预后不佳的危险因素,且TIBI分级和DRAGON评分单独及联合均对患者术后1周内预后不佳具有一定的临床预测效能。

【Objective】To explore the predictive value of DRAGON score combined with TIBI within 24 hours after mechanical thrombectomy for acute ischemic cerebral infarction.【Methods】A total of 98 patients with acute ischemic cerebral infarction who underwent mechanical thrombectomy in our hospital were selected for the study.Both 24 hour DRAGON score and TIBI grading at 24 hours after operation were evaluated.Patients were further divided into the poor prognosis group and good prognosis group according to their prognosis within 1 week after operation.Logistic multivariate regression analysis was used to explore the related factors affecting the prognosis of 1 week after mechanical thrombectomy.The receiver operating characteristic curve(ROC)was used to analyze the predictive value of DRAGON score and TIBI grading alone and in combination on recurrence of cerebral infarction within 1 week after operation.【Results】Among the ninety-eight patients,fifty-eight patients had a poor prognosis within 1 week after surgery(the poor prognosis group),accounting for 59.18%.The forty patients had a good prognosis(the good prognosis group),accounting for 40.82%.The poor prognosis group had a poor baseline CTA collateral compensation score,the proportion of TIBI grades 0 to 3,and the DRAGON score level were higher than those in the good prognosis group(P<0.05).The results of Logistic multivariate regression analysis showed that the poor baseline CTA collateral compensation score,the proportion of TIBI grades 0 to 3,and the high DRAGON score were all risk factors for poor prognosis within 1 week after surgery(P<0.05).ROC analysis showed that the area under the curve(AUC)of TIBI classification,DRAGON score and the combination of the two for acute ischemic cerebral infarction undergoing mechanical thrombectomy were 0.769,0.785,and 0.839,respectively.The TIBI grades or DRAGON score alone had lower predictive value for poor prognosis within 1 week after operation than the combination of the two(P<0.05).【Conclusion】TIBI grades 0 to 3 and high DRAGON scores are risk factors for poor prognosis in patients with acute ischemic cerebral infarction who underwent mechanical thrombectomy within 1 week after surgery.TIBI grading and DRAGON score alone and in combination have certain clinical predictive value in predicting the prognosis of patients with cerebral infarction undergoing mechanical thrombectomy within 1 week after surgery.