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损害动态大脑自我调节是预测不良预后的血液动力学标志物,即使在内血管血栓切除术后进行良好的再通道化,也是如此

Liu Ran^1,2, Pingping Wang³, Hongxiu Chen^1,2

¹Department of Vascular Ultrasound, Xuanwu Hospital, Capital Medical University, Xicheng, Beijing, China.

Brain circulation

|April 24, 2024

概括

动态大脑自身调节 (dCA) 在急性缺血性中风 (AIS) 内血管内血栓切除术 (EVT) 后受损. 缺陷的dCA预测这些患者的临床结果不佳.

科学领域:

神经学神经学
神经外科神经外科
血管医学血管医学

背景情况:

内血管血栓切除术 (EVT) 是急性缺血性中风 (AIS) 的关键治疗方法.
动态大脑自调节 (dCA) 对于通过减轻血压波动来维持稳定的脑血流在EVT期间至关重要.
了解dCA在EVT后的作用对于预测患者的结果至关重要.

研究的目的:

研究动态大脑自我调节 (dCA) 在预测AIS患者EVT后临床结果中的作用.
评估EVT后的dCA损伤是否与神经损伤和功能结果有关.

主要方法:

一项病例控制研究,涉及43名接受EVT的AIS患者和43名健康对照.
在EVT后12小时和5天使用跨的多普勒测试来评估dCA参数 (相位,增益,连贯性).
用修改的兰金尺度 (mRS) 在3个月后评估了临床结果;后勤回归确定了风险因素.

主要成果:

在EVT后的ipsilateral侧观察到显著的dCA损伤,特别是在不良结果的患者中 (mRS3-6).
在EVT后5天的ipsilateral阶段与功能性结果差显著相关 (调整后OR=0.911,P=0.005).
从12小时到5天的阶段变化EVT后独立预测的临床结果 (调整后OR=1.061,P=0.008).

结论:

动态大脑自身调节 (dCA) 在急性缺血性中风 (AIS) 后的EVT患者中明显受损.
在接受EVT治疗的AIS患者中,dCA功能的变化是临床结果的独立预测因素.

关键词:

头部和部成像扫描仪神经学神经学神经学一次性中风中风中风中风中风超声波超声波是指超声波的使用.血管外科手术血管外科

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