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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Predictors of Symptomatic Intracranial Hemorrhage after Endovascular Therapy in Acute Ischemic Stroke with Large Vessel Occlusion
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Predictors of Symptomatic Intracranial Hemorrhage after Endovascular Therapy in Acute Ischemic Stroke with Large Vessel Occlusion

机译：大容器闭塞急性缺血性脑卒中血管内颅内出血的预测因素

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摘要

Background: The symptomatic intracranial hemorrhage (SICH) is a serious complication of endovascular therapy (EVT) in acute ischemic stroke (AIS) with large vessel occlusion. We aimed to clarify the predictors of SICH after EVT in patients with internal carotid artery (ICA) or proximal M1 segment of middle cerebral artery occlusions. Methods: Among 1442 AIS patients with large vessel occlusion admitted within 24 hours after onset between July 2010 and June 2011, 226 patients with ICA or proximal M1 occlusions were treated with EVT. SICH was defined as any type of intracranial hemorrhage with a decline in the National Institutes of Health Stroke Scale (NIHSS) score >= 4. Results: Of the 226 patients, 204 with sufficient data were analyzed. SICH was observed in 10 patients (4.9%). Baseline NIHSS score (22 versus 17), serum glucose level (206 mg/dL versus 140 mg/dL), and prior antiplatelet therapy (60.0% versus 21.7%) were significantly higher in patients with SICH than in those without (all P < .01). With receiver operating characteristic analyses, the optimal cutoff values for predicting SICH were NIHSS score >= 19 and serum glucose >= 160 mg/dL. In multivariate analysis, glucose level >= 160 mg/dL (odds ratio: 11.89; 95% confidence interval [CI]: 2.79-65.08), prior antiplatelet therapy (odds ratio: 8.03; 95% CI: 1.83-41.70), and NIHSS score >= 19 (odds ratio: 7.78; 95% CI: 1.63-59.44) were independent predictors of SICH. Conclusion: Hyperglycemia, prior antiplatelet therapy, and high baseline NIHSS score were associated with SICH after EVT in AIS patients with ICA or proximal M1 occlusions. (C) 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.
机译：背景：症状颅内出血（SICH）是大血管闭塞的急性缺血性中风（AIS）中血管疗法（EVT）的严重并发症。我们旨在阐明患有内部颈动脉（ICA）或近端M1段的中脑动脉闭塞患者的EVT后的SICH预测因子。方法：在2010年7月至2011年7月24小时内24小时内录取的1442例AIS闭塞患者，226例ICA或近端M1闭塞的226名患有EVT。 SICH被定义为任何类型的颅内出血，国家卫生卒中量表（NIHSS）评分> = 4.结果：226例患者，分析了足够的数据。在10名患者中观察到Sich（4.9％）。基线NIHSS得分（22与17次），血清葡萄糖水平（206mg / dl为140 mg / dl），并且先前的抗血小板治疗（60.0％对21.7％）显着高于中间的患者（所有P < .01）。通过接收器操作特征分析，预测SICH的最佳截止值是NIHSS得分> = 19和血清葡萄糖> = 160mg / dL。在多变量分析中，葡萄糖水平> = 160mg / dl（差距：11.89; 95％置信区间[CI]：2.79-65.08），先前抗血小板治疗（赔率比：8.03; 95％CI：1.83-41.70），和NIHSS得分> = 19（赔率比：7.78; 95％CI：1.63-59.44）是SICH的独立预测因子。结论：高血糖，先前抗血小板治疗和高基线NIHSS评分与ICA或近端M1闭塞的AIS患者EVT后的SICH相关。 （c）2017国家冲程协会。由elsevier Inc.保留所有权利发布。

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