脑静脉窦血栓形成患者临床及MRI/MRV特征与抗凝治疗预后的相关性分析

The Correlation Analysis of Clinical and MRI/MRV Characteristics with Anticoagulant Therapy Prognosis in Patients with Cerebral Venous Sinus Thrombosis

目的探讨MRI联合MRV及相关临床特征预测脑静脉窦血栓患者经抗凝治疗后不同预后的评价指标;指导临床尽早干预治疗,改善患者的预后。方法收集47例徐州医科大学附属医院2017年1月至2023年2月经MRI联合MRV确诊的脑静脉窦血栓形成患者的临床及影像学资料,回顾性分影响CVST患者抗凝治疗预后的病因、临床特征及MRI及MRV的影像特点等。结果单因素分析年龄(P=0.014)、D-二聚体(P=0.039)、静脉性梗死合并出血(P=0.044)、局灶性神经功能缺损(P=0.002)、侧支循环(P=0.014)在不同预后分组中的差异有统计学意义;多因素二元logistic回归分析显示局灶性神经功能缺损(OR=58.138,95%CI:1.423-2374.543,P=0.032)是CVST患者短期预后不良的独立危险因素,侧支循环1级(OR=0.008,95%CI:0.000-0.807,P=0.040)是预后良好的保护因素。结论局灶性神经功能缺损是CVST患者短期预后不良的独立危险因素,侧支循环1级与CVST患者预后良好独立相关。

Objective To explore the evaluation indicators of MRI combined with MRV and related clinical features in predicting different prognosis of patients with cerebral venous sinus thrombosis after anticoagulation treatment;Guide clinical early intervention and treatment to improve patient prognosis.Methods Clinical and imaging data of 47 patients with cerebral venous sinus thrombosis diagnosed by MRI combined with MRV at the Affiliated Hospital of Xuzhou Medical University from January 2017 to February 2023 were collected.The causes,clinical features,and imaging features of MRI and MRV that affect the prognosis of anticoagulation therapy in CVST patients were retrospectively analyzed.Results Univariate analysis revealed significant age differences(P=0.014),D-dimer levels(P=0.039),venous infarction with bleeding(P=0.044),focal neurological deficits(P=0.002),and collateral circulation(P=0.014)across various prognostic groups.Multifactorial binary logistic regression analysis showed that focal neurologic deficit(OR=58.138,95%CI:1.423-2374.543,P=0.032)was an independent risk factor for poor short-term prognosis in CVST patients,and collateral circulation grade 1(OR=0.008,95%CI:0.000-0.807,P=0.040)was a protective factor for good prognosis.Conclusion Focal neurological impairment is an autonomous risk aspect for adverse short-term prognosis among patients with CVST,and collateral circulation level 1 is independently associated with good prognosis in CVST patients.