急性后循环大血管闭塞血管内治疗预后的危险因素分析

Analysis of Risk Factors for Prognosis After Endovascular Treatment of Acute Posterior Circulation Large Vessel Occlusion

目的探讨急性后循环大血管闭塞血管内治疗后90 d预后的危险因素。方法回顾性分析2019年3月—2023年6月江苏大学附属宜兴医院神经外科收治的64例患者资料,均为急性后循环大血管闭塞并行血管内治疗的病例。根据患者术后90 d改良Rankin量表(modified rankin score,mRS)评分,mRS评分≤2分者为预后良好组,mRS评分≥3分者为预后不良组,将基线资料、临床资料及随访资料行组间比较。先行单因素分析筛选出危险因素,再行多因素logistic回归分析。结果共入组64例患者,其中预后良好组25例,预后不良组39例,单因素分析结果显示,2组间术前美国国立卫生研究院卒中量表(National Institutes of Health stroke scale,NIHSS)评分及基底动脉闭塞血管造影侧支分级(angiographic collateral grading system for basilar artery occlusion,ACGS-BAO)比较,差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,术前NIHSS评分≥20分及ACGS-BAO分级≤2级与不良预后相关,2组比较差异有统计学意义(P<0.05)。结论急性后循环大血管闭塞血管内治疗术后90 d不良预后与术前高NIHSS评分,低ACGS-BAO分级相关。

Objective To explore the risk factors for prognosis after 90 d of endovascular treatment for acute posterior circulation large vessel occlusion.Methods A total of 64 patients with acute posterior circulation large vessel occlusion were recruited who received endovascular treatment in the department of neurosurgery,Affiliated Yixing Hospital,Jiangsu University from March 2019 to June 2023.According to the mRS score of patients 90 days after surgery,patients were divided into a good prognosis group(patients with mRS≤2 points)and a poor prognosis group(patients with mRS≤3 points).The baseline data,clinical data and follow-up data between the two groups were compared.Single factor analysis was used to screen the risk factors for poor prognosis,then multivariate logistic regression analysis was performed.Results A total of 64 patients were divided into the good prognosis group(25 cases)and the poor prognosis group(39 cases).Univariate analysis showed that there were significant difference in preoperative NIHSS score and ACGS-BAO grading between two groups(P<0.05).The results of multivariate logistic regression analysis showed that there were significant difference in preoperative NIHSS score≤20 points and ACGS-BAO grading≤2 levels between two groups(P<0.05).Conclusion Preoperative NIHSS score≤20 points,ACGSBAO grade≤2 are associated with poor prognosis 90 days after endovascular treatment for acute posterior circulation occlusion.