在内血管治疗后出现或没有症状的内出血的急性缺血性中风:一种倾向性-得分匹配研究
Xiaoxi Zhang1,2, Fang Shen1, Luo Rui2
1Neurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Journal of neurointerventional surgery
|August 6, 2024
概括
在急性缺血性中风的内血管治疗后,无症状的内出血与较差的功能结果有关. 这种风险在老年患者和那些具有严重中风特征的患者中增大.
科学领域:
- 神经学 神经学
- 干预神经病学 干预神经病学
- 脑卒中医学 脑卒中医学
背景情况:
- 对于急性缺血性中风的内血管治疗 (EVT) 后无症状内出血 (aICH) 的影响尚未完全理解.
- 在EVT后对aICH的长期随访的现实数据有限且有争议.
研究的目的:
- 为了研究无症状内出血 (aICH) 与急性缺血性中风进行EVT的患者的功能性结局之间的关联.
- 在现实临床环境中评估aICH的效果,使用倾向性得分匹配的前数据库.
主要方法:
- 一项观察性队列研究包括732名患有前部循环封闭症的患者,这些患者接受了EVT治疗和成功的再输血.
- 用倾向分数加权的多变量逻辑回归和1:1 PS匹配的队列来分析结果.
- 主要结局是功能独立,定义为90天后Rankin尺度 (mRS) 修改得分为0-2的功能独立.
主要成果:
- 在匹配后,分析了418名患有aICH和348名没有aICH的患者.
- 与没有aICH的患者相比,90天后患者的功能结果 (mRS 0-2) 显著恶化 (37.8%与55.5%,P<0.001).
- 在aICH组中,与更糟糕的结果相关的因素包括年龄较大,NIHSS较高,ASPECTS较低和全身麻醉.
结论:
- 对于急性缺血性中风,EVT后无症状的内出血与更糟糕的功能结果有关.
- 在老年患者和那些具有严重的临床和放射性中风特征的患者中,aICH的负面影响更为明显.
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