缺血型烟雾病患者行血运重建术后再发脑梗死的影响因素

Analysis of the risk factors for recurrent cerebral infarction after revascularization in patients with ischemic moyamoya disease

目的探究缺血型烟雾病患者行血运重建术后再发脑梗死的危险因素。方法以2016-03—2018-12于郑州大学第五附属医院行血运重建术的92例缺血型烟雾病患者为研究对象,针对其临床资料和随访资料进行回顾性分析,采用多因素Logistic回归方法分析缺血型烟雾病患者血运重建术后再发脑梗死的危险因素。结果92例患者至随访结束时均存活,其中12例术后至随访结束再发脑梗死,其余80例术后无脑梗死。多因素Logistic回归分析表明术前Suzuki分期(OR=75.102,95%CI3.781~1491.721,P=0.005)、mRS评分(OR=15.712,95%CI 1.975~124.975,P=0.009)可影响术后再发脑梗死的概率。结论烟雾病应早期手术,及时在Suzuki分期的早期和mRS评分较低的阶段进行手术,术后再发脑梗死的风险相对较小,手术效果更好。

Objective To explore the risk factors related to recurrent cerebral infarction after revascularization In patients with ischemic moyamoya disease.Methods Totally 92 patients with ischemic moyamoya disease that underwent extracranial-intracranial revascularization from March 2016 to December 2018 in the Fifth Affiliated Hospital of Zhengzhou University were included,in which their clinical and follow-up data were retrospectively analyzed.Multivariate Logistic regression model was used to analyze the risk factors for recurrent cerebral infarction after revascularization in patients with ischemic moyamoya disease.Results All the 92 patients survived until the end of follow-up,and no patients died.Twelve patients after surgery had recurrent cerebral infarction by the end of follow-up,while the remaining 80 patients did not.Multivariate Logistic regression analysis showed that preoperative Suzuki’s stage(OR=75.102,95%CI:3.781-1491.721,P=0.005)and mRS score(OR=15.712,95%CI:1.975-124.975,P=0.009)could affect the probability of postoperative recurrent cerebral infarction.Conclusion For the moyamoya disease patients,revascularization surgery should be performed at early Suzuki’s stage and low mRS score,so that the risk of postoperative recurrent cerebral infarction is lower and the surgical effect is better.