摘要
目的探讨术前年龄和NIHSS两者相结合的指标SPAN指数、wSPAN指数、SC评分对急性缺血性卒中(AIS)患者血管内治疗术后临床预后之间的关系。方法连续收集2015年8月—2021年10月就诊于中国3个综合性卒中中心接受血管内治疗的AIS患者889例,以门诊或电话方式随访90天。根据术后90天改良Rankin量表(90 d mRS)评分评估患者预后,分为预后良好组(mRS≤2分)和预后不良组(mRS>2分)。同时记录患者术后症状性颅内出血(sICH)、颅内出血转化的发生率及术后90天死亡率。结果在纳入的889例患者中,预后不良组血管内治疗前的SPAN指数、wSPAN指数、SC评分均显著高于预后良好组(P<0.001)。在调整潜在的混杂因素后,SPAN、wSPAN、SC均与EVT患者90天预后独立相关(SPAN:OR=0.961,95%CI=0.948-0.975、wSPAN:OR=0.968,95%CI=0.959-0.976、SC:OR=0.767,95%CI=0.713-0.826)。SPAN、wSPAN、SC与sICH之间没有统计学差异(P=0.220,P=0.088,P=0.072),而与颅内出血转化风险增加(SPAN:OR=1.03,95%CI=1.02-1.05,P<0.001、wSPAN:OR=1.03,95%CI=1.02-1.03,P<0.001、SC:OR=1.25,95%CI=1.14-1.36,P<0.001)和死亡率(P<0.001,P<0.001,P<0.001)相关。结论术前SPAN指数、wSPAN指数、SC评分与AIS患者血管内治疗90天临床预后、颅内出血转化发生率和高死亡率相关,但与sICH无关。
Objective To investigate the relationship between SPAN index(combined by preoperative age and NIHSS),wSPAN index and SC score and clinical prognosis of patients with acute ischemic stroke(AIS)after endovascular therapy(EVT).Methods 889 AIS patients who received endovascular treatment at 3 comprehensive stroke centers in China from August 2015 to October 2021 were continuously collected,they were followed-up for 90 days at outpatient department or on the phone.The score of modified Rankin scale(mRS)was used to evaluate the prognosis at 90 days after operation,and according to the results the patients were divided into good prognosis group(mRS≤2)and poor prognosis group(mRS>2).Meanwhile,symptomatic intracranial hemorrhage(sICH)after operation,the incidence of ntracranial hemorrhage transformation,and mortality within 90 days after operation were recorded.Results Totally 889 patients were included in the study.The SPAN index,wSPAN index and SC score of the poor prognosis group were significantly higher than those of the good prognosis group before endovascular therapy(P<0.001).After the adjustment of potential confounders,SPAN,wSPAN and SC were independently correlated with 90d prognosis after endovascular treatment in AIS patients(SPAN:OR=0.961,95%CI=0.948-0.975;wSPAN:OR=0.968,95%CI=0.959-0.976;SC:OR=0.767,95%CI=0.713-0.826).There were no statistical differences between SPAN,wSPAN,SC and sICH(P=0.220,P=0.088,P=0.072),however,they were associated with an increased risk of intracranial hemorrhage transformation(SPAN:OR=1.03,95%CI=1.02-1.05,P<0.001;wSPAN:OR=1.03,95%CI=1.02-1.03 P<0.001;SC:OR=1.25,95%CI=1.14-1.36,P<0.001)and mortality(P<0.001,P<0.001,P<0.001).Conclusions The preoperative SPAN index,wSPAN index and SC score are associated with the clinical prognosis within 90 days,intracranial hemorrhage transformation rate and high mortality among AIS patients after endovascular therapy,but not correlated with sICH.
作者
马岚
陆悠
孙越
黄皇凰
方珉
Ma Lan;Lu You;Sun Yue;Huang Huanghuang;Fang Min(Medical school,Anhui University of Science and Technology,Huainan,Anhui,232001,China;Department of neurology,Shanghai tenth people’s hospital(the tenth affiliated people’s hospital of Tongji University),Shanghai,200072,China)
出处
《齐齐哈尔医学院学报》
2023年第2期101-106,共6页
Journal of Qiqihar Medical University
基金
上海市卫生健康委员会项目(202040086)
上海市自然基金委员会项目(16ZR1426300)。
