早期心脏病发作增长率与内血管血栓切除术后的症状性内出血有关
Wei Wang1, Zhihang Huang1, Shuaiyu Chen1
1Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.
Therapeutic advances in neurological disorders
|December 20, 2024
概括
通过明显扩散系数 (ADC) 测量的早期心脏病发作增长率 (EIGR) 可以预测在接受内血管血栓切除 (EVT) 的缺血性中风患者中症状性内出血 (sICH) 风险. 这一发现有助于在EVT后更好地选择和管理患者.
科学领域:
- 神经学 神经学
- 放射学 放射学是一门学科.
- 医疗成像医学成像
背景情况:
- 从中风开始的时间和基线心脏病发作量显著影响内血管血栓切除术 (EVT) 后的结果.
- 预测像症状性内出血 (sICH) 这样的并发症对于优化EVT患者管理至关重要.
研究的目的:
- 评估早期心脏病发作增长率 (EIGR) 对EVT后缺血性中风患者的sICH的预测效用.
- 评估通过明显扩散系数 (ADC) 测量的EIGR与sICH风险之间的关联.
主要方法:
- 追溯分析315名缺血性中风患者,前部循环中大血管封闭,接受了EVT.
- EIGR计算为缺血核心体积 (ADC ≤620 × 10-6 mm2/s) 分于从中风开始到成像的时间.
- 使用海德堡出血分类,在EVT后72小时内诊断出sICH.
主要成果:
- 症状性内出血 (sICH) 在11.4%的患者中发生.
- 增加的EIGR独立地与更高的SICH风险相关 (aOR=1.033,p=0.001).
- 在加上常规风险因素 (NRI=0.393,p=0.001;IDI=0.245,p=0.001) 时,EIGR显著改善了sICH的风险重新分类.
结论:
- 提升的早期心脏病发作增长率 (EIGR) 在接受EVT的患者中可以作为症状性内出血 (sICH) 的有价值预测指标.
- 将EIGR纳入风险模型可以提高sICH的预测,并可能指导治疗决策.
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