Department of Radiology, Pudong New Area People's Hospital, Shanghai, China.
Department of Radiology, Shanghai Pudong New Area Hospital of Traditional Chinese Medicine, China.
Adv Clin Exp Med. 2021 Feb;30(2):183-188. doi: 10.17219/acem/121927.
In recent years, the clinical significance of collateral circulation in vascular embolism has been gradually found.
To investigate the relationship between collateral circulation and short-term prognosis of wake-up stroke patients.
The present observational study enrolled 269 cases of wake-up ischemic stroke patients. All patients presented with mismatched low perfusion volume/main infraction volume and received thrombolytic therapy after admission. The hemorrhagic transformation rate was recorded. The American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) grading was used for evaluation of collateral circulation. The stroke condition was determined using the National Institutes of Health Stroke Scale (NIHSS). The Barthel Index (BI) score was used for measurement of quality of life. The Modified Rankin Scale (mRS) was used for measurement of prognosis.
The hypertension, diabetes and current smoker rates were significantly higher. The baseline NHISS scores and NIHSS scores after 24 h were remarkably lower. The NIHSS scores were markedly lower in ASITN/SIR grade 2-3 patients compared with ASITN/SIR grade 0-1 patients at 1 week, 2 weeks, 4 weeks, and 3 months after treatment. Patients with ASITN/SIR grade 2-3 had lower mRS score and higher BI scores. The ASITN/SIR grade was an independent risk factor for bad prognosis of wake-up ischemic stroke patients in 3 months.
Collateral circulation condition may be associated with short-term prognosis of wake-up stroke patients. Patients with worse collateral circulation may present higher risk for bad short-term prognosis.
近年来，侧支循环在血管栓塞中的临床意义逐渐被发现。
探讨侧支循环与觉醒型脑卒中患者短期预后的关系。
本观察性研究纳入 269 例觉醒型缺血性脑卒中患者。所有患者均表现为低灌注量/主梗死体积不匹配，并在入院后接受溶栓治疗。记录出血转化率。采用美国介入治疗与治疗神经放射学会/介入放射学会（ASITN/SIR）分级评估侧支循环。采用美国国立卫生研究院卒中量表（NIHSS）评估卒中情况。采用巴氏指数（BI）评分评估生活质量。采用改良 Rankin 量表（mRS）评估预后。
高血压、糖尿病和当前吸烟者的比例显著升高。基线 NIHSS 评分和入院 24 h 后 NIHSS 评分显著降低。与 ASITN/SIR 0-1 级患者相比，ASITN/SIR 2-3 级患者治疗后 1 周、2 周、4 周和 3 个月的 NIHSS 评分明显降低。ASITN/SIR 2-3 级患者 mRS 评分较低，BI 评分较高。ASITN/SIR 分级是觉醒型缺血性脑卒中患者 3 个月预后不良的独立危险因素。
侧支循环状况可能与觉醒型脑卒中患者的短期预后相关。侧支循环较差的患者短期预后不良的风险可能更高。
