急性轻度卒中伴大血管闭塞或狭窄患者的深入血流动力学评估。
In-depth hemodynamic assessment in acute mild stroke patients with large vessel occlusion or stenosis.
机构信息
Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
出版信息
BMC Neurol. 2024 Nov 4;24(1):426. doi: 10.1186/s12883-024-03939-y.
OBJECTIVE
Acute treatment in mild stroke patients with acute anterior circulation large vessel occlusion/stenosis (AACLVO/S) had limited evidence. Hemodynamic play an important role in neurological deterioration. We aimed to investigate predictor value of hemodynamic assessment for clinical outcome predicting and guiding individual therapeutic decisions in those patients.
METHODS
We retrospectively analyze the stroke database in our stroke center. We recruited patients with mild stroke, defined by National Institutes of Health Stroke Scale (NIHSS) score ≤ 5, caused by AACLVO/S treated with just medical management (MT). They all received cerebral autoregulation (CA) assessments within 72 h after stroke onset. The primary end point was clinical outcome at 90-day after stroke.
RESULTS
Logistic regression analysis showed that bilateral higher baseline phase difference (PD) were independent variables related to favorable 90-day outcome, (OR 0.963, 95% CI 0.936-0.991, p = 0.040; OR 0.943, 95% CI 0.970-0.997; p = 0.008, respectively). The optimal cutoff value of bilateral PD was > 34.97º and > 14.29º respectively.
CONCLUSION
CA evaluation can provide hemodynamic status in mild stroke patients with AACLVO/S.
目的
急性前循环大血管闭塞/狭窄（AACLVO/S）的轻度卒中患者的急性治疗证据有限。血流动力学在神经功能恶化中起着重要作用。我们旨在研究血流动力学评估对这些患者的临床预后预测和指导个体化治疗决策的预测价值。
方法
我们回顾性分析了我们卒中中心的卒中数据库。我们招募了由 AACLVO/S 引起的轻度卒中患者，定义为国立卫生研究院卒中量表（NIHSS）评分≤5，仅接受药物治疗（MT）。他们都在卒中发病后 72 小时内接受了脑自动调节（CA）评估。主要终点是卒中后 90 天的临床结局。
结果
逻辑回归分析表明，双侧基线相位差（PD）较高是与 90 天预后良好相关的独立变量，（OR 0.963，95%CI 0.936-0.991，p=0.040；OR 0.943，95%CI 0.970-0.997；p=0.008）。双侧 PD 的最佳截断值分别为>34.97°和>14.29°。
结论
CA 评估可为 AACLVO/S 的轻度卒中患者提供血流动力学状态。
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