School of Clinical Medicine, University of Electronic Science and Technology of China, Chengdu 610054, China; Department of Neurology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, The Afliated Hospital of University of Electronic Science and Technology of China, Chengdu 610072, China.
Department of Neurology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, The Afliated Hospital of University of Electronic Science and Technology of China, Chengdu 610072, China.
J Clin Neurosci. 2023 Nov;117:120-124. doi: 10.1016/j.jocn.2023.09.030. Epub 2023 Oct 4.
Long-term prognosis and factors influencing endovascular therapy (EVT) remain unclear. This study aimed to investigate the association between computed tomography perfusion (CTP) parameters and long-term prognosis of patients with acute ischemic stroke (AIS) treated with EVT. Patients with AIS due to large vessel occlusion treated with EVT were prospectively included for a 1-year follow-up. All patients and their data were grouped based on the hypoperfusion intensity ratio (HIR, ＜0.3 vs. ≥ 0.3) and cerebral blood volume (CBV) index (＞0.7 vs. ≤ 0.7). The primary outcome was favorable prognosis, defined as a modified Rankin Scale (mRS) score of 0-2. Multivariate logistic regression was used to analyze factors influencing long-term favorable prognosis. Of 69 patients included, 35 (50.7 %) achieved mRS 0-2 at one year. A favorable prognosis was observed predominantly in patients with higher CBV index (75.0 % vs. 34.1 %, p= 0.001) and lower HIR (72.0 % vs. 38.6 %, p=0.008). In the multivariate logistic regression, CBV index (odds ratio (OR) = 4.362; 95 % confidence interval (CI): 1.052, 18.082; p = 0.042), baseline National Institutes of Health Stroke Scale (NIHSS) score (OR = 0.913; 95 % CI: 0.836, 0.997; p = 0.044), and symptomatic intracranial hemorrhage (sICH) (OR = 0.089; 95 % CI: 0.009, 0.925; p = 0.043) were independently associated with a long-term favorable prognosis. The CBV index may serve as a predictor of the long-term prognosis of patients treated with EVT. The novel finding is that the baseline NIHSS score and sICH were associated with long-term prognosis.
长期预后和影响血管内治疗（EVT）的因素仍不清楚。本研究旨在探讨急性缺血性卒中（AIS）患者接受 EVT 治疗后 CT 灌注（CTP）参数与长期预后的关系。前瞻性纳入了接受 EVT 治疗的大血管闭塞性 AIS 患者进行 1 年随访。所有患者及其数据均根据低灌注强度比（HIR，＜0.3 与≥0.3）和脑血容量（CBV）指数（＞0.7 与≤0.7）进行分组。主要结局为改良 Rankin 量表（mRS）评分 0-2 的良好预后。多变量 logistic 回归分析影响长期良好预后的因素。69 例患者中，35 例（50.7%）在 1 年时 mRS 评分为 0-2。较高的 CBV 指数（75.0%与 34.1%，p=0.001）和较低的 HIR（72.0%与 38.6%，p=0.008）患者预后较好。多变量 logistic 回归分析显示，CBV 指数（比值比（OR）=4.362；95%置信区间（CI）：1.052，18.082；p=0.042）、基线国立卫生研究院卒中量表（NIHSS）评分（OR=0.913；95%CI：0.836，0.997；p=0.044）和症状性颅内出血（sICH）（OR=0.089；95%CI：0.009，0.925；p=0.043）与长期良好预后独立相关。CBV 指数可能是 EVT 治疗患者长期预后的预测因子。新发现是基线 NIHSS 评分和 sICH 与长期预后相关。
