取栓术治疗急性大血管闭塞性脑梗死预后的影响因素分析

Influencing factors of prognosis of thrombectomy on patients with acute great vascular occlusive cerebral infarction

目的分析取栓术治疗急性大血管闭塞性脑梗死预后的影响因素。方法抽取2019年1月至2022年8月于聊城市第三人民医院行取栓术治疗的206例急性大血管闭塞性脑梗死患者作为研究对象,按照3个月改良Rankin量表(mRS)评分分为预后不良组(56例,mRS评分>2分)、预后良好组(150例,mRS评分0~2分)。收集可能与取栓术相关的资料,行单因素及多因素Logistic回归分析,筛选影响取栓术预后的相关因素。结果行二元Logistic回归分析结果显示,房颤(OR=3.08,95%CI=1.597~5.939)、溶栓前美国国立卫生院卒中量表(NIHSS)评分(OR=2.78,95%CI=1.709~4.518)、血糖(OR=1.49,95%CI=1.316~6.022)、发病至靶血管开通时间(OR=1.74,95%CI=1.154~2.639)、取栓术后24 h内收缩压(OR=2.82,95%CI=1.320~4.466)、取栓术后24 h内舒张压(OR=2.43,95%CI=0.892~6.610)均是取栓术后患者预后不良的独立危险因素(P均<0.05)。结论合并房颤、溶栓前NIHSS评分高、血糖水平高、发病至靶血管复流时间过长、取栓术后高血压均是取栓术预后不良的独立危险因素。

Objective To analyze the influencing factors of prognosis of thrombectomy on patients with acute great vascular occlusive cerebral infarction.Methods A total of 206 patients with acute great vascular occlusive cerebral infarction who underwent thrombectomy in Liaocheng Third People’s Hospital from January 2019 to August 2022 were selected as study subjects.According to the 3-month modified Rankin scale(mRS)score,the selected patients were divided into poor prognosis group(56 cases,mRS score>2)and good prognosis group(150 cases,mRS score 0-2).The data likely to be relevant to thrombectomy were collected.Univariate and multivariate logistic regression analysis were performed to screen the related factors affecting the prognosis of thrombectomy.Results The results of binary logistic regression analysis showed that atrial fibrillation(OR=3.08,95%CI=1.597-5.939),National Institutes of Health stroke scale(NIHSS)score before thrombolysis(OR=2.78,95%CI=1.709-4.518),blood glucose(OR=1.49,95%CI=1.316-6.022),time from onset to thrombectomy(OR=1.74,95%CI=1.154-2.639),systolic blood pressure within 24 hours after thrombectomy(OR=2.82,95%CI=1.320-4.466),diastolic blood pressure within 24 hours after thrombectomy(OR=2.43,95%CI=0.892-6.610)were independent risk factors for poor prognosis(all P<0.05).Conclusions Atrial fibrillation,high NIHSS score before thrombectomy,high level of blood glucose,long duration from onset to endovascular reperfusion,and hypertension after thrombectomy are all independent risk factors for poor prognosis of thrombectomy.