慢性鼻窦炎在接受机械取栓治疗的急性缺血性卒中患者中的预后作用
Prognostic Role of Chronic Rhinosinusitis in Acute Ischemic Stroke Patients Undergoing Mechanical Thrombectomy.
作者信息
Puz Przemysław, Stryjewska-Makuch Grażyna, Żak Amadeusz, Rybicki Wiktor, Student Sebastian, Lasek-Bal Anetta
机构信息
Department of Neurology, School of Health Sciences, Medical University of Silesia, ul. Ziołowa 45, 40-653 Katowice, Poland.
Department of Neurology, Leszek Giec Upper-Silesian Medical Centre, Silesian Medical University, ul. Ziołowa 45, 40-653 Katowice, Poland.
出版信息
J Clin Med. 2021 Sep 27;10(19):4446. doi: 10.3390/jcm10194446.
BACKGROUND
The aim of the study was to assess the relevance of chronic rhinosinusitis (CRS) CT features to the efficacy of mechanical thrombectomy (MT) in patients with acute ischemic stroke.
METHODS
This study included 311 patients qualified for MT in whom the CRS features were assessed based on a CT scan, according to the Lund-Mackay (L-M) score. Clinical, inflammatory parameters, patients neurological (NIHSS) and functional status (mRS), and recanalisation efficacy (TICI) were compared between patients with mild lesions (L-M score 0-3 points)-group 1, and patients with more severe lesions (L-M score 4-24)-group 2.
RESULTS
There was a significant difference in the NIHSS on day seven after stroke onset-10 points in group 1 and 14 points in group 2, = 0.02. NIHSS ≤ 6 points on day seven was found in 41.9% of patients in group 1, and in 27.5% in group 2, = 0.042. There were no significant differences in mRS score and in the TICI score. L-M score, lipid abnormalities and CRP were factors associated with NIHSS ≥ 7 points on day 7.
CONCLUSIONS
The CT features of CRS may be used as a prognostic tool for early prognosis assessment in stroke patients.
背景
本研究旨在评估慢性鼻窦炎（CRS）CT特征与急性缺血性脑卒中患者机械取栓术（MT）疗效的相关性。
方法
本研究纳入311例符合MT条件的患者，根据Lund-Mackay（L-M）评分，基于CT扫描评估CRS特征。比较轻度病变患者（L-M评分0 - 3分）——第1组，与重度病变患者（L-M评分4 - 24分）——第2组之间的临床、炎症参数、患者神经功能（美国国立卫生研究院卒中量表[NIHSS]）和功能状态（改良Rankin量表[mRS]）以及再通疗效（脑梗死溶栓分级[TICI]）。
结果
卒中发作后第7天，两组患者的NIHSS存在显著差异——第1组为10分，第2组为14分，P = 0.02。第1组41.9%的患者在第7天NIHSS≤6分，第2组为27.5%，P = 0.042。mRS评分和TICI评分无显著差异。L-M评分、脂质异常和C反应蛋白（CRP）是与第7天NIHSS≥7分相关的因素。
结论
CRS的CT特征可作为脑卒中患者早期预后评估的预后工具。
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