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血管内治疗的动脉瘤性蛛网膜下腔出血患者完全功能恢复的预测因素。

Predictors of full functional recovery in endovascularly treated patients with aneurysmal subarachnoid hemorrhage.

机构信息

Department of Radiology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey

出版信息

Turk J Med Sci. 2021 Aug 30;51(4):2000-2006. doi: 10.3906/sag-2103-3.

Abstract

BACKGROUND/AIM: The knowledge of factors influencing functional outcomes after aneurysmal subarachnoid hemorrhage (ASH) has significantly increased in recent decades, still not enough. We aimed to identify the predictors of full functional recovery (FFR) in endovascularly treated patients with ASH.

MATERIALS AND METHODS

A retrospective review was performed of adult patients who underwent endovascular treatment for ASH in a 5-year period. The association was evaluated of variables with FFR, defined as a modified Rankin Scale score of 0 or 1 at a 3-month follow-up.

RESULTS

This study included 204 patients with a percentage of FFR of 62.7%. On univariate analysis, the following variables were associated with FFR: younger age, male sex, no history of hypertension, posterior circulation aneurysm, better modified-Fisher grade (mFG), better Hunt-Hess grade, better Glasgow Coma score, lower platelet-to-lymphocyte ratio (PLR), lower neutrophil-to-lymphocyte ratio (NLR), and higher platelet-to-neutrophil ratio (PNR). On multivariate analysis, younger age (OR = 0.95, 95% Cl = 0.92–0.98, p = 0.003), better mFG (OR = 0.66, 95% Cl = 0.48–0.97, p = 0.03), lower PLR (OR = 0.993, 95% Cl = 0.990–0.997, p = 0.001), lower NLR (OR = 0.89, 95% Cl = 0.83–0.95, p = 0.01) and higher PNR (OR = 1.08, 95% Cl = 1.01–1.10, p = 0.01) showed the strongest association with FFR.

CONCLUSION

With the administration of endovascular treatment, most of the patients with ASH can return to a normal productive life. Younger age, better mFG, lower PLR and NLR, as well as higher PNR, increase the likelihood of FFR.

摘要

背景/目的:近几十年来,人们对影响颅内动脉瘤性蛛网膜下腔出血(aSAH)患者功能预后的因素有了更深入的了解,但仍不够全面。本研究旨在确定接受血管内治疗的 aSAH 患者完全功能恢复(FFR)的预测因素。

材料和方法

回顾性分析了 5 年内接受血管内治疗的 aSAH 成年患者的资料。评估了与 FFR 相关的变量与 3 个月随访时改良 Rankin 量表(mRS)评分为 0 或 1 的相关性。

结果

本研究共纳入 204 例患者,FFR 占比为 62.7%。单因素分析显示,以下变量与 FFR 相关:年龄较小、男性、无高血压病史、后循环动脉瘤、更好的改良 Fisher 分级(mFG)、更低的 Hunt-Hess 分级、更好的格拉斯哥昏迷评分(GCS)、更低的血小板与淋巴细胞比值(PLR)、更低的中性粒细胞与淋巴细胞比值(NLR)、更高的血小板与中性粒细胞比值(PNR)。多因素分析显示,年龄较小(OR=0.95,95%CI:0.92-0.98,p=0.003)、更好的 mFG(OR=0.66,95%CI:0.48-0.97,p=0.03)、更低的 PLR(OR=0.993,95%CI:0.990-0.997,p=0.001)、更低的 NLR(OR=0.89,95%CI:0.83-0.95,p=0.01)和更高的 PNR(OR=1.08,95%CI:1.01-1.10,p=0.01)与 FFR 相关性最强。

结论

在接受血管内治疗后,大多数 aSAH 患者可以恢复正常的生产生活。年龄较小、更好的 mFG、更低的 PLR 和 NLR 以及更高的 PNR 可提高 FFR 的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a04/8569787/0d79bf3d1d31/turkjmedsci-51-2000-fig001.jpg

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