摘要
目的探讨Tan评分对急性大脑中动脉(AMCA)M1段闭塞患者溶栓效果的评估价值。方法选取156例接受静脉溶栓治疗的AMCAM1段闭塞患者,根据脑梗死溶栓(TICI)血管灌注分级将患者分为未通组94例和再通组62例。比较两组基础资料和Tan评分,多因素Logistic回归分析AMCAM1段闭塞患者溶栓未通影响因素。受试者工作特征(ROC)曲线分析Tan评分预测AMCAM1段闭塞患者溶栓未通价值,比较不同Tan评分患者改良Rankin量表(mRS)分级。结果未通组Tan评分<2分、高血压史、心房颤动史比例和入院时国立卫生研究院卒中量表(NIHSS)评分、空腹血糖(FPG)、低密度脂蛋白胆固醇(LDL-C)、尿酸(UA)、C反应蛋白(CRP)水平高于再通组,发病至入院时间长于再通组(P均<0.05)。多因素Logistic回归分析显示,高血压史(OR=4.318,95%CI:2.405~8.276)、发病至入院时间(OR=1.076,95%CI:1.025~1.128)、入院时NIHSS评分(OR=1.170,95%CI:1.081~1.395)为AMCAM1段闭塞患者溶栓未通独立危险因素(P均<0.05),Tan评分≥2分(OR=0.316,95%CI:0.160~0.627)为保护因素(P<0.05)。ROC曲线结果显示,Tan评分预测AMCAM1段闭塞患者溶栓未通的曲线下面积、灵敏度、特异度分别为0.849(95%CI:0.783~0.901)、77.17%、85.94%。Tan评分<2分患者mRS分级≥3级比例高于Tan评分≥2分患者(P<0.05)。结论Tan评分与AMCAM1段闭塞患者溶栓效果有关,可作为溶栓未通的评估指标。
Objective To investigate the evaluation value of Tan score on thrombolysis in patients with acute middle cerebral artery(AMCA)M1 segment occlusion.Methods We selected 156 cases of AMCA M1 segment occlusion pa⁃tients treated with intravenous thrombolysis,and the patients were divided into the unpassed(n=94)and recanalized(n=62)groups according to the thrombolysis in cerebral infarction(TICI)vascular perfusion classification.We compared the base information and Tan scores between the two groups.Multifactorial Logistic regression analysis was used to analyze the factors influencing the failure of thrombolysis in patients with AMCA M1 segment occlusion.The receiver operating charac⁃teristic(ROC)curve of subjects was used to analyze the value of Tan score to predict thrombolysis failure in patients with AMCA M1 occlusion.We compared the modified Rankin Scale(mRS)grading among patients with different Tan scores.Results Tan score<2,history of hypertension,proportion of history of atrial fibrillation and National Institutes of Health Stroke Scale(NIHSS)score on admission,fasting blood glucose(FPG),low-density lipoprotein cholesterol(LDL-C),uric acid(UA),and C-reactive protein(CRP)levels were significantly higher in the unpassed group than in the recana⁃lised group,and the time from onset to admission was significantly longer in the unpassed group than in the recanalised group(all P<0.05).Multifactorial Logistic regression analysis showed that history of hypertension(OR=4.318,95%CI:2.405-8.276),time from onset to admission(OR=1.076,95%CI:1.025-1.128),and NIHSS score at admission(OR=1.170,95%CI:1.081-1.395)were independent risk factor for thrombolysis failure in patients with AMCA M1 segment occlusion,and Tan score≥2(OR=0.316,95%CI:0.160-0.627)was a protective factor(P<0.05).The ROC curve showed that the area under the curve(AUC),sensitivity and specificity of the Tan score in predicting thrombolysis failure in patients with AMCA M1 segment occlusion were 0.849(95%CI:0.783-0.901),77.17%,and 85.94%,respective⁃ly.Conclusion Tan score is related to thrombolytic outcome in patients with AMCA M1 segment occlusion and can be used as a predictor of thrombolysis failure.
作者
张雪娟
赵琨
ZHANG Xuejuan;ZHAO Kun(Department of Neurology,Tianjin Baodi Hospital,Tianjin 301800,China)
出处
《山东医药》
CAS
2022年第34期21-25,共5页
Shandong Medical Journal
基金
天津市科技计划项目(17ZXMJSY0058)。
关键词
急性缺血性脑卒中
大脑中动脉M1段闭塞
静脉溶栓
侧支循环
Tan评分
acute ischemic stroke
middle cerebral artery M1 segment occlusion
intravenous thrombolysis
collat⁃eral circulation
Tan score
