基于CTP对急性缺血性脑卒中介入取栓治疗的临床预后研究

Clinical Prognostic Study on Intermediary Thrombolytic Therapy for Acute Ischemic Stroke Based on CTP

目的 研究探讨CTP技术对AIS介入取栓术患者的预后评估价值。方法 收集83例AIS行MT术的患者临床资料进行回顾性分析,按mRS评分分为预后良好组52例和预后不良组31例,按m CTA评分分为侧支循环良好组54例和侧支循环不良组29例,按NIHSS评分分为神经缺损明显改善组48例和神经缺损无明显改善组35例,分别对比不同分组患者术后1周的CTP灌注参数。结果 预后良好组患者的CTP灌注参数CBF、CBV和HIR值均明显高于预后不良组(P<0.05);侧支循环良好组患者的CTP灌注参数CBF、CBV和HIR值均明显高于侧支循环不良组(P<0.05);神经缺损明显改善组患者的CTP灌注参数CBF、CBV和HIR值明显高于神经缺损无明显改善组(P<0.05)。结论 CTP技术对AIS行MT术后患者的梗死灶核心体积、缺血半暗带等参数进行测量,可有效对术后侧支循环状态、神经功能缺损程度及总体预后进行评估,为临床预测HT风险和制定下一步治疗方案提供科学参考依据。

Objective To investigate the prognostic evaluation value of CTP technology in AIS patients undergoing interventional thrombectomy.Method Clinical data of 83 AIS patients undergoing MT surgery were collected for retrospective analysis.They were divided into a good prognosis group of 52 cases and a poor prognosis group of 31 cases according to the mRS score.According to the mCTA score,they were divided into a good collateral circulation group of 54 cases and a poor collateral circulation group of 29 cases.According to the NIHSS score,they were divided into a significantly improved nerve defect group of 48 cases and a no significant improvement nerve defect group of 35 cases.The CTP perfusion parameters of patients in different groups were compared one week after surgery.Result The CTP perfusion parameters CBF,CBV,and HIR values of patients with good prognosis were significantly higher than those of patients with poor prognosis(P<0.05);The CTP perfusion parameters CBF,CBV,and HIR values of patients with good collateral circulation were significantly higher than those of patients with poor collateral circulation(P<0.05);The CTP perfusion parameters CBF,CBV,and HIR values of patients with significantly improved neurological deficits were significantly higher than those of patients with no significant improvement in neurological deficits(P<0.05).Conclusion CTP technology can effectively evaluate the postoperative collateral circulation status,degree of neurological dysfunction,and overall prognosis of AIS patients undergoing MT surgery by measuring parameters such as infarct core volume and ischemic penumbra.It provides a scientific reference for clinical prediction of HT risk and the formulation of next step treatment plans.