摘要
目的通过分析急性缺血性脑卒中(acute ischemic stroke,AIS)患者接受机械取栓治疗后不同大脑中动脉高密度征(HMCAS),探讨HMCAS对患者侧支循环状态及临床预后的影响。方法回顾性分析行机械取栓治疗的150例AIS患者临床资料,根据HMCAS情况,将其分为HMCAS阳性组和HMCAS阴性组,比较两组患者基础资料、治疗效果和预后情况。结果两组患者在TOAST分型方面比较差异具有统计学意义(P=0.001),且HMCAS阳性组患者发病至动脉穿刺时间、发病至血管再通时间均短于HMCAS阴性组(P<0.001);HMCAS阳性组患者侧支循环良好率显著低于HMCAS阴性组(P=0.001),但两组患者血管再通成功率比较差异无统计学意义(P>0.05);HMCAS阳性组患者90 d mRS评分显著高于HMCAS阴性组(P<0.001),NIHSS评分显著高于HMCAS阴性组(P<0.001);HMCAS阳性组预后良好率显著低于HMCAS阴性组(P=0.015)。结论与HMCAS阳性患者比较,HMCAS阴性患者在机械取栓后,侧支循环建立情况和临床预后情况均相对较好,通过监测急性缺血性脑卒中HMCAS,能够在一定程度上预测治疗效果。
Objective By analyzing different hyperdense middle cerebral artery sign(HMCAS)in patients with acute ischemic stroke(AIS)after mechanical thrombectomy,the influence of HMCAS on the collateral circu-lation status and clinical prognosis of patients was explored.Methods The clinical data of 150 AIS patients who underwent mechanical thrombolysis were retrospectively analyzed,and they were divided into HMCAS positive and HMCAS negative groups according to HMCAS,comparing the basic data,therapeutic effect and prognosis of the two groups.Results There was a statistically significant difference in TOAST classification between the two groups(P=0.001).Moreover,HMCAS positive group had significantly shorter onset-to-arterial puncture time and onset-to-recanalization time compared to HMCAS negative group(P<0.001).HMCAS positive group had a significantly lower rate of good collateral circulation compared to HMCAS negative group(P=0.001).However,there was no statistically significant difference in the successful recanalization rate between the two groups(P>0.05).Patients in HMCAS positive group had significantly higher 90 d mRS scores than those in HMCAS negative group(P<0.001)and significantly higher NIHSS scores than those in HMCAS negative group(P<0.001).The rate of good prognosis in HMCAS positive group was significantly lower than that in HMCAS negative group(P=0.015).Conclusion Compared with HMCAS positive patients,HMCAS negative patients demonstrated better collateral circulation establishment and clinical prognosis after mechanical thrombectomy.Monitoring HMCAS in acute ischemic stroke may help predict therapeutic efficacy to some extent.
作者
柴旺
魏爱宣
贾晓静
CHAI Wang;WEI Aixuan;JIA Xiaojing(Affiliated Hospital of Beihua University,Jilin 132011,China;Jilin Central Hospital,Jilin 132011,China)
出处
《北华大学学报(自然科学版)》
2025年第5期626-630,共5页
Journal of Beihua University(Natural Science)
基金
吉林省教育厅科学技术研究项目(JJKH20230082KJ)。
关键词
大脑中动脉高密度征
急性缺血性脑卒中
机械取栓
侧支循环
临床预后
hyperdense middle cerebral artery sign
acute ischemic stroke
mechanical thrombectomy
collateral circulation
clinical prognosis
