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急性缺血性脑卒中患者血管内治疗后发病时间与功能结局的关系。

Association between the time of day at stroke onset and functional outcome of acute ischemic stroke patients treated with endovascular therapy.

机构信息

Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China.

Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.

出版信息

J Cereb Blood Flow Metab. 2022 Dec;42(12):2191-2200. doi: 10.1177/0271678X221111852. Epub 2022 Jul 5.

Abstract

To investigate the association between time-of-day of stroke onset and functional outcome in patients with acute ischemic stroke(AIS) treated with endovascular thrombectomy(EVT). AIS patients treated with EVT between January 2013 and December 2018 were recruited and divided them into four 6-h interval groups according to the time-of-day of stroke onset. A total of 438 patients were enrolled, 3-month favorable outcome were achieved in 58.6%, 43.7%, 36.6%, and 30.5% of patients in the 00:00-06:00, 06:00-12:00, 12:00-18:00, and 18:00-24:00 groups, respectively (adjusted OR 0.61, 95% CI 0.40-0.93;  = 0.020). Compared with the 18:00-24:00 interval, patients in the 00:00-06:00 interval (adjusted OR 4.01, 95%CI 1.02-15.80,  = 0.047) and the 06:00-12:00 interval (adjusted OR 3.24, 95% CI 1.09-9.64,  = 0.034) were more likely to achieve favorable outcome. The time-of-day of stroke onset was not associated with 3-month mortality (adjusted 0.829), symptomatic intracerebral hemorrhage (sICH, adjusted  = 0.296), or early successful recanalization (adjusted  = 0.074). In conclusion, in AIS patients treated with EVT, those onsets either between 00:00 and 06:00 or between 06:00 and 12:00 appeared to be associated with a higher proportion of favorable outcomes at 3 months, but the time-of-day at stroke onset was not associated with the incidence of sICH, rate of early successful recanalization, or 3-month mortality.

摘要

研究目的

探讨急性缺血性脑卒中(AIS)患者血管内血栓切除术(EVT)后发病时间与功能结局的相关性。

研究方法

回顾性分析 2013 年 1 月至 2018 年 12 月期间接受 EVT 的 AIS 患者,根据发病时间将其分为 4 个 6 小时间隔组。共纳入 438 例患者,00:00-06:00、06:00-12:00、12:00-18:00 和 18:00-24:00 组患者发病 3 个月后的预后良好率分别为 58.6%、43.7%、36.6%和 30.5%(校正比值比 0.61,95%可信区间 0.40-0.93; = 0.020)。与 18:00-24:00 组相比,00:00-06:00 组(校正比值比 4.01,95%可信区间 1.02-15.80, = 0.047)和 06:00-12:00 组(校正比值比 3.24,95%可信区间 1.09-9.64, = 0.034)患者更有可能获得良好的预后。发病时间与 3 个月死亡率(校正比值比 0.829)、症状性颅内出血(sICH,校正比值比 = 0.296)或早期再通率(校正比值比 = 0.074)无关。

研究结论

在接受 EVT 的 AIS 患者中,00:00-06:00 或 06:00-12:00 之间发病似乎与 3 个月时更好的预后相关,但发病时间与 sICH 发生率、早期再通率或 3 个月死亡率无关。

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