目的:使用Meta分析的方法比较单纯抗凝治疗与血管内治疗颅内静脉窦血栓形成(CVST)的安全性与有效性。方法:检索PubMed、Embase、知网、维普、万方数据库,检索时限从2000年1月1日开始至2023年12月31日。应用RevManV 5.4软件对纳入的文献...目的:使用Meta分析的方法比较单纯抗凝治疗与血管内治疗颅内静脉窦血栓形成(CVST)的安全性与有效性。方法:检索PubMed、Embase、知网、维普、万方数据库,检索时限从2000年1月1日开始至2023年12月31日。应用RevManV 5.4软件对纳入的文献进行Meta分析。结果:共有7篇符合要求的文献纳入分析,总计CVST患者489人,其中血管内治疗组240人,单纯抗凝治疗组249人。Meta分析结果显示,血管内治疗组治疗后mRS评分低于单纯抗凝治疗(MD = −0.38, 95% CI: −0.46~−0.30, P 2 = 60%, P = 0.02)。治疗后血管再通率血管内治疗组优于单纯抗凝治疗组(OR = 6.55, 95% CI: 2.70~15.90, P Objective: To compare the safety and efficacy of intravascular treatment versus anticoagulation alone for cerebral venous sinus thrombosis (CVST) using a Meta-analysis approach. Methods: Digital libraries, including PubMed, Embase, CNKI, Wanfang, and VIP, were searched for relevant studies published from January 1, 2000, to December 31, 2023. The included studies were assessed using RevManV 5.4 software for data extraction and quality evaluation. Results: A total of seven eligible studies involving 489 CVST patients (240 in the intravascular treatment group and 249 in the anticoagulation group) were included in the analysis. The Meta-analysis results showed that post-treatment modified Rankin Scale (mRS) scores were significantly lower in the intravascular treatment group compared to the anticoagulation group (MD = −0.38, 95% CI: −0.46~−0.30, P 2 = 60%, P = 0.02). The rate of vascular re-establishment after treatment was significantly higher in the intravascular treatment group (OR = 6.55, 95% CI: 2.70~15.90, P < 0.05). However, there were no statistically significant differences between the groups in terms of post-treatment mortality (OR = 0.86, 95% CI: 0.25~2.96, P = 0.81) or the incidence of bleeding events (OR = 0.34, 95% CI: 0.10~1.16, P = 0.09). Conclusions: Compared to anticoagulation alone, intravascular treatment improves clinical symptoms and increases the rate of vascular re-establishment in CVST patients without affecting the incidence of bleeding events or mortality rates. These findings highlight the potential benefits of intravascular treatment in enhancing patient outcomes while maintaining safety.展开更多
目的分析支架机械取栓与抗凝治疗颅内静脉窦血栓形成的效果及预后影响因素。方法回顾性收集丽水市人民医院2016年6月至2023年6月期间收治的86例颅内静脉窦血栓(CVST)患者的临床资料,根据治疗方式将其分为支架组(n=43)和抗凝组(n=43),比...目的分析支架机械取栓与抗凝治疗颅内静脉窦血栓形成的效果及预后影响因素。方法回顾性收集丽水市人民医院2016年6月至2023年6月期间收治的86例颅内静脉窦血栓(CVST)患者的临床资料,根据治疗方式将其分为支架组(n=43)和抗凝组(n=43),比较两组治疗前后的神经元特异性烯醇化酶(NSE)水平、脑源性神经营养因子(BDNF)水平、重组VILIP1蛋白(rVILIP1)、美国国立卫生研究院卒中量表(NIHSS)评分及不良反应。随访90 d后,根据改良Rankin量表(mRS)评分将研究对象分为预后良好组(n=56,mRS≤2分)和预后不良组(n=30,mRS>2分),采用二元Logistic回归分析影响CVST患者预后的因素,ROC曲线分析预后的影响因素及联合预测模型对CVST患者预后的评价效能。结果治疗后,两组NSE、rVILIP1水平降低,BDNF水平升高,且支架组各指标均优于抗凝组(均P<0.05)。支架组的不良反应发生率低于抗凝组(P<0.05)。和预后不良组相比,预后良好组的发病至治疗时间更低、合并高血压少、术后再通不良少、术后24 h NIHSS评分低,差异均有统计学意义(均P<0.05)。Logistic回归分析显示发病至治疗时间长、高血压、术后再通不良及术后24 h NIHSS评分高是影响CVST患者预后的独立危险因素(均P<0.05)。发病至治疗时间、高血压、术后再通不良、术后24 h NIHSS评分及联合预测的曲线下面积(AUC)分别为0.747、0.668、0.761、0.738、0.926,敏感度分别为0.667、0.804、0.821、0.667、0.833,特异性分别为0.875、0.533、0.700、0.839、0.893。联合检测的AUC均高于单个指标,且敏感度和特异度均为最优。结论和传统抗凝治疗相比,支架机械取栓能够有效减轻CVST患者的神经损伤,且安全性良好。发病至治疗时间长、高血压、术后再通不良、术后24 h NIHSS评分高是影响CVST患者预后的独立危险因素。展开更多
文摘目的:使用Meta分析的方法比较单纯抗凝治疗与血管内治疗颅内静脉窦血栓形成(CVST)的安全性与有效性。方法:检索PubMed、Embase、知网、维普、万方数据库,检索时限从2000年1月1日开始至2023年12月31日。应用RevManV 5.4软件对纳入的文献进行Meta分析。结果:共有7篇符合要求的文献纳入分析,总计CVST患者489人,其中血管内治疗组240人,单纯抗凝治疗组249人。Meta分析结果显示,血管内治疗组治疗后mRS评分低于单纯抗凝治疗(MD = −0.38, 95% CI: −0.46~−0.30, P 2 = 60%, P = 0.02)。治疗后血管再通率血管内治疗组优于单纯抗凝治疗组(OR = 6.55, 95% CI: 2.70~15.90, P Objective: To compare the safety and efficacy of intravascular treatment versus anticoagulation alone for cerebral venous sinus thrombosis (CVST) using a Meta-analysis approach. Methods: Digital libraries, including PubMed, Embase, CNKI, Wanfang, and VIP, were searched for relevant studies published from January 1, 2000, to December 31, 2023. The included studies were assessed using RevManV 5.4 software for data extraction and quality evaluation. Results: A total of seven eligible studies involving 489 CVST patients (240 in the intravascular treatment group and 249 in the anticoagulation group) were included in the analysis. The Meta-analysis results showed that post-treatment modified Rankin Scale (mRS) scores were significantly lower in the intravascular treatment group compared to the anticoagulation group (MD = −0.38, 95% CI: −0.46~−0.30, P 2 = 60%, P = 0.02). The rate of vascular re-establishment after treatment was significantly higher in the intravascular treatment group (OR = 6.55, 95% CI: 2.70~15.90, P < 0.05). However, there were no statistically significant differences between the groups in terms of post-treatment mortality (OR = 0.86, 95% CI: 0.25~2.96, P = 0.81) or the incidence of bleeding events (OR = 0.34, 95% CI: 0.10~1.16, P = 0.09). Conclusions: Compared to anticoagulation alone, intravascular treatment improves clinical symptoms and increases the rate of vascular re-establishment in CVST patients without affecting the incidence of bleeding events or mortality rates. These findings highlight the potential benefits of intravascular treatment in enhancing patient outcomes while maintaining safety.
文摘目的分析支架机械取栓与抗凝治疗颅内静脉窦血栓形成的效果及预后影响因素。方法回顾性收集丽水市人民医院2016年6月至2023年6月期间收治的86例颅内静脉窦血栓(CVST)患者的临床资料,根据治疗方式将其分为支架组(n=43)和抗凝组(n=43),比较两组治疗前后的神经元特异性烯醇化酶(NSE)水平、脑源性神经营养因子(BDNF)水平、重组VILIP1蛋白(rVILIP1)、美国国立卫生研究院卒中量表(NIHSS)评分及不良反应。随访90 d后,根据改良Rankin量表(mRS)评分将研究对象分为预后良好组(n=56,mRS≤2分)和预后不良组(n=30,mRS>2分),采用二元Logistic回归分析影响CVST患者预后的因素,ROC曲线分析预后的影响因素及联合预测模型对CVST患者预后的评价效能。结果治疗后,两组NSE、rVILIP1水平降低,BDNF水平升高,且支架组各指标均优于抗凝组(均P<0.05)。支架组的不良反应发生率低于抗凝组(P<0.05)。和预后不良组相比,预后良好组的发病至治疗时间更低、合并高血压少、术后再通不良少、术后24 h NIHSS评分低,差异均有统计学意义(均P<0.05)。Logistic回归分析显示发病至治疗时间长、高血压、术后再通不良及术后24 h NIHSS评分高是影响CVST患者预后的独立危险因素(均P<0.05)。发病至治疗时间、高血压、术后再通不良、术后24 h NIHSS评分及联合预测的曲线下面积(AUC)分别为0.747、0.668、0.761、0.738、0.926,敏感度分别为0.667、0.804、0.821、0.667、0.833,特异性分别为0.875、0.533、0.700、0.839、0.893。联合检测的AUC均高于单个指标,且敏感度和特异度均为最优。结论和传统抗凝治疗相比,支架机械取栓能够有效减轻CVST患者的神经损伤,且安全性良好。发病至治疗时间长、高血压、术后再通不良、术后24 h NIHSS评分高是影响CVST患者预后的独立危险因素。
