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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Prognosis of Subtypes of Acute Large Artery Atherosclerotic Cerebral Infarction by Evaluation of Established Collateral Circulation
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Prognosis of Subtypes of Acute Large Artery Atherosclerotic Cerebral Infarction by Evaluation of Established Collateral Circulation

机译：抵押品循环评价急性大动脉动脉粥样硬化脑梗死脑梗死的预后

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摘要

Background: The prognosis of acute ischemic stroke is related to collateral circulation, which is different with different pathogenesis. Objective: To explore the prognosis of acute large atherosclerotic (LAA) cerebral infarction with different pathogenesis by assessing the establishment of collateral circulation. Methods: 108 patients with acute LAA cerebral infarction in our hospital, who failed to thrombolytic or thrombectomy in the acute phase were selected and classified by Chinese ischemic stroke subclassification (CISS). They were evaluated by National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS). CT angiography (CTA) of head and neck were used to evaluate the collateral circulation for patients with large vessel stenosis or occlusion within one week of admission. The CTA collateral scores (CS) were recorded in a dichotomized fashion (ie, poor vs good). Results: Patients with good CS had significantly lower NIHSS score and good prognosis at 2 weeks and 3 months than patients with poor CS (P < 0.001). The arterial-to-arterial embolization mechanism was the highest in the ratio of good CS and good prognosis at 3 months (P < 0.001). Multivariate Logistic regression analysis showed that baseline NIHSS score (OR=1.407, 95%CI:1.153-1.717, P=0.001) was an independent factor affecting poor CS. The NIHSS score at baseline (OR=0.604, 95%CI:0.436-0.837, P=0.002) and good CS (OR=39.552, 95%CI:8.908-175.618, P=0.000) were important predictors of good prognosis at 3 months. Conclusion: The prognosis and collateral circulation of acute LAA cerebral infarction with different pathogenesis was different. Baseline NIHSS score and collateral circulation had great impact on prognosis at 3 months.
机译：背景：急性缺血性脑卒中的预后与侧支循环有关，侧支循环因发病机制不同而不同。目的：通过评估侧支循环的建立，探讨不同发病机制的急性大动脉粥样硬化（LAA）性脑梗死的预后。方法：选择我院急性期未行溶栓或取栓术的急性LAA脑梗死患者108例，按中国缺血性卒中分类（CISS）进行分类。采用美国国立卫生研究院卒中量表（NIHSS）和改良Rankin量表（mRS）进行评估。头颈部CT血管造影（CTA）用于评估入院后一周内大血管狭窄或闭塞患者的侧支循环。CTA侧枝评分（CS）以二分法（即差与好）记录。结果：CS好的患者在2周和3个月时NIHSS评分和预后均显著低于CS差的患者（P<0.001）。动脉间栓塞机制在3个月时CS良好和预后良好的比率最高（P<0.001）。多变量逻辑回归分析显示，基线NIHSS评分（OR=1.407，95%CI:1.153-1.717，P=0.001）是影响不良CS的独立因素。基线检查时的NIHSS评分（OR=0.604，95%CI:0.436-0.837，P=0.002）和良好的CS（OR=39.552，95%CI:8.908-175.618，P=0.000）是3个月预后良好的重要预测因素。结论：不同发病机制的急性LAA脑梗死的预后和侧支循环不同。基线NIHSS评分和侧支循环对3个月时的预后有很大影响。

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