Acute ischemic stroke is one of the leading causes of morbidity and mortality worldwide.Restoration of cerebral blood flow to affected ischemic areas has been the cornerstone of therapy for patients for eligible patie...Acute ischemic stroke is one of the leading causes of morbidity and mortality worldwide.Restoration of cerebral blood flow to affected ischemic areas has been the cornerstone of therapy for patients for eligible patients as early diagnosis and treatment have shown improved outcomes.However,there has been a paradigm shift in the management approach over the last decade,and with the emphasis currently directed toward including newer modalities such as neuroprotection,stem cell treatment,magnetic stimulation,anti-apoptotic drugs,delayed recanali-zation,and utilization of artificial intelligence for early diagnosis and suggesting algorithm-based management protocols.展开更多
目的 探讨急性缺血性脑卒中(acute ischemic stroke, AIS)患者溶栓后脑血流与缺血再灌注损伤及神经功能的相关性。方法 回顾性选取2021年2月至2024年2月唐山市工人医院神经内科收治的AIS患者150例,根据溶栓后CT灌注成像检查患侧脑血流量...目的 探讨急性缺血性脑卒中(acute ischemic stroke, AIS)患者溶栓后脑血流与缺血再灌注损伤及神经功能的相关性。方法 回顾性选取2021年2月至2024年2月唐山市工人医院神经内科收治的AIS患者150例,根据溶栓后CT灌注成像检查患侧脑血流量(cerebral blood flow, CBF)变化情况分为高灌注组48例和低灌注组102例。获取出血转化情况及灌注参数资料,后者包括CBF、脑血容量(cerebral blood volume, CBV)、残余功能达峰时间(time to maximum of the residual function, T_(max))、平均通过时间(mean transit time, MTT)和达峰时间(time to peak, TTP),以及相对值rCBF、rCBV、T_(r, max)、rMTT及rTTP。比较2组一般临床资料、氧化应激、美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale, NIHSS)评分和炎性因子水平。采用Pearson/Spearman相关性分析AIS患者溶栓后rCBF与氧化应激、炎性因子、出血转化情况及NIHSS评分的相关性。结果 低灌注组患侧MTT、T_(max)、TTP显著高于健侧,CBF显著低于健侧,差异有统计学意义(P<0.01)。高灌注组患侧MTT、TTP显著低于健侧,CBF、CBV显著高于健侧,差异有统计学意义(P<0.01)。低灌注组rMTT、T_(r, max)、rTTP显著高于高灌注组,rCBF、rCBV显著低于高灌注组(P<0.01)。低灌注组丙二醛、晚期氧化蛋白产物、肿瘤坏死因子α、C反应蛋白水平显著低于高灌注组,超氧化物歧化酶水平显著高于高灌注组,差异有统计学意义(P<0.05,P<0.01)。Pearson相关性分析显示,rCBF与丙二醛、肿瘤坏死因子α呈负相关(r=-0.436,P<0.01;r=-0.451,P<0.01),与超氧化物歧化酶呈正相关(r=0.412,P<0.01)。结论 AIS患者溶栓后脑血流变化与缺血再灌注损伤存在较好相关性,但与神经功能恢复情况不具备显著相关性。展开更多
文摘Acute ischemic stroke is one of the leading causes of morbidity and mortality worldwide.Restoration of cerebral blood flow to affected ischemic areas has been the cornerstone of therapy for patients for eligible patients as early diagnosis and treatment have shown improved outcomes.However,there has been a paradigm shift in the management approach over the last decade,and with the emphasis currently directed toward including newer modalities such as neuroprotection,stem cell treatment,magnetic stimulation,anti-apoptotic drugs,delayed recanali-zation,and utilization of artificial intelligence for early diagnosis and suggesting algorithm-based management protocols.
文摘目的 探讨急性缺血性脑卒中(acute ischemic stroke, AIS)患者溶栓后脑血流与缺血再灌注损伤及神经功能的相关性。方法 回顾性选取2021年2月至2024年2月唐山市工人医院神经内科收治的AIS患者150例,根据溶栓后CT灌注成像检查患侧脑血流量(cerebral blood flow, CBF)变化情况分为高灌注组48例和低灌注组102例。获取出血转化情况及灌注参数资料,后者包括CBF、脑血容量(cerebral blood volume, CBV)、残余功能达峰时间(time to maximum of the residual function, T_(max))、平均通过时间(mean transit time, MTT)和达峰时间(time to peak, TTP),以及相对值rCBF、rCBV、T_(r, max)、rMTT及rTTP。比较2组一般临床资料、氧化应激、美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale, NIHSS)评分和炎性因子水平。采用Pearson/Spearman相关性分析AIS患者溶栓后rCBF与氧化应激、炎性因子、出血转化情况及NIHSS评分的相关性。结果 低灌注组患侧MTT、T_(max)、TTP显著高于健侧,CBF显著低于健侧,差异有统计学意义(P<0.01)。高灌注组患侧MTT、TTP显著低于健侧,CBF、CBV显著高于健侧,差异有统计学意义(P<0.01)。低灌注组rMTT、T_(r, max)、rTTP显著高于高灌注组,rCBF、rCBV显著低于高灌注组(P<0.01)。低灌注组丙二醛、晚期氧化蛋白产物、肿瘤坏死因子α、C反应蛋白水平显著低于高灌注组,超氧化物歧化酶水平显著高于高灌注组,差异有统计学意义(P<0.05,P<0.01)。Pearson相关性分析显示,rCBF与丙二醛、肿瘤坏死因子α呈负相关(r=-0.436,P<0.01;r=-0.451,P<0.01),与超氧化物歧化酶呈正相关(r=0.412,P<0.01)。结论 AIS患者溶栓后脑血流变化与缺血再灌注损伤存在较好相关性,但与神经功能恢复情况不具备显著相关性。
