富含红细胞的血栓与血清铁有关，通过血管内治疗有助于急性缺血性脑卒中单次支架取栓和获得良好的临床结局。
Erythrocyte-rich thrombi related to serum iron contribute to single stent retrieval and favorable clinical outcomes in acute ischemic stroke by endovascular treatment.
机构信息
The Department of Neurosurgery, Second Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, Heilongjiang Province, China.
The Department of Neurosurgery, Second Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, Heilongjiang Province, China.
出版信息
Thromb Res. 2020 Nov;195:8-15. doi: 10.1016/j.thromres.2020.06.038. Epub 2020 Jun 25.
BACKGROUND
Erythrocyte-rich thrombi seem to be associated with favorable clinical outcomes of patients with AIS by endovascular treatment (EVT), as observed from previous studies. However, only few studies show whether erythrocyte-rich thrombi can be associated with favorable clinical outcomes by EVT and which factor can be related to erythrocyte-rich thrombi. This retrospective study aimed to evaluate the relationship between erythrocyte-rich thrombi and favorable clinical outcomes and further explored factors associated with erythrocyte-rich thrombi.
METHODS
This study was carried out retrospectively from March 2016 to April 2019 on patients who suffered acute ischemic stroke and were treated by EVT at this stroke center. The laboratory test and clinical data were assessed for the relationship between erythrocyte-rich thrombi and favorable clinical outcomes and factors associated with erythrocyte-rich thrombi. All thrombi were divided into erythrocyte-rich thrombi group and fibrin-rich thrombi group based on the proportion of area of the predominant composition which was more than 50% in retrieved thrombi.
RESULTS
This retrospective study enrolled 84 patients, including 32 patients in the erythrocyte-rich thrombi group and 52 patients in the fibrin-rich thrombi group. It showed single stent retrieval (p = 0.017, adjusted OR: 4.061, 95% CI: 1.281-12.872) and favorable clinical outcomes (p < 0.001, adjusted OR: 14.648, 95% CI: 4.637-46.270) were both significantly associated with erythrocyte-rich thrombi. A significant difference in the factor associated with erythrocyte-rich thrombi was serum iron, which correlated positively with erythrocyte fraction in thrombi (p < 0.001, r: 0.452).
CONCLUSIONS
Erythrocyte-rich thrombi could contribute to single stent retrieval and favorable clinical outcomes by EVT, and serum iron might be the factor associated with erythrocyte-rich thrombi.
背景
从之前的研究中可以看出，富含红细胞的血栓似乎与急性缺血性脑卒中（AIS）患者血管内治疗（EVT）的良好临床结局相关。然而，只有少数研究表明 EVT 后富含红细胞的血栓是否与良好的临床结局相关，以及哪些因素与富含红细胞的血栓相关。本回顾性研究旨在评估富含红细胞的血栓与良好临床结局之间的关系，并进一步探讨与富含红细胞的血栓相关的因素。
方法
本研究于 2016 年 3 月至 2019 年 4 月在该卒中中心接受 EVT 治疗的急性缺血性脑卒中患者中进行回顾性研究。评估实验室检查和临床资料与富含红细胞的血栓和与富含红细胞的血栓相关的因素之间的关系。所有血栓均根据回收血栓中主要成分的面积比例大于 50%，分为富含红细胞的血栓组和富含纤维蛋白的血栓组。
结果
本回顾性研究共纳入 84 例患者，其中富含红细胞的血栓组 32 例，富含纤维蛋白的血栓组 52 例。研究表明，单支架取栓（p=0.017，调整后的 OR：4.061，95%CI：1.281-12.872）和良好的临床结局（p<0.001，调整后的 OR：14.648，95%CI：4.637-46.270）均与富含红细胞的血栓显著相关。与富含红细胞的血栓相关的因素中，血清铁具有显著差异，与血栓中的红细胞分数呈正相关（p<0.001，r：0.452）。
结论
富含红细胞的血栓可促进 EVT 后的单支架取栓和良好的临床结局，血清铁可能是与富含红细胞的血栓相关的因素。
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