Qu Yang, Cong Menglu, Liu Jia, Zhang Pan-Deng, Shen Zi-Duo, Zhang Han, Sun Yingying, Zhu Hongjing, Li Chao, Zhang Peng, Chang Junlei, Zhang Kejia, Ren Jiaxin, Jin Hang, Sun Xin, Yang Yi, Guo Zhen-Ni
Stroke Center, Department of Neurology, The First Hospital of Jilin University, Changchun, China.
Laboratory for Engineering and Scientific Computing, Institute of Advanced Computing and Digital Engineering, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.
CNS Neurosci Ther. 2025 Mar;31(3):e70323. doi: 10.1111/cns.70323.
To investigate the characteristics of dynamic cerebral autoregulation (dCA) in patients after mechanical thrombectomy (MT) and the relationship between dCA and prognosis.
In this prospective study, 89 and 158 patients were enrolled in the MT and non-MT groups, respectively. Both groups underwent dCA measurements within 3 days after stroke. The transfer function parameter, phase difference (PD), and gain were used to quantify dCA. A favorable outcome was defined as a modified Rankin Scale score ≤ 2 at 90 days. The collateral score was used to reflect the collateral reserve capacity.
MT was associated with better PD in both the affected and unaffected sides. In the MT group, the PD of the affected side was an independent predictor of favorable outcomes (odds ratio [OR] 0.927, 95% confidence interval [CI] 0.885-0.970; p < 0.001). The area under the receiver operating characteristic curve for predicting favorable outcomes of the PD on the affected side was 0.759 (95% CI, 0.654-0.864; p < 0.001). Further, good collaterals were independently associated with better PD.
MT has a positive effect on dCA during the acute phase of stroke. For patients undergoing MT, dCA is a reliable indicator for predicting prognosis and may be an intervention target to improve outcomes.
研究机械取栓术（MT）后患者的动态脑自动调节（dCA）特征以及dCA与预后的关系。
在这项前瞻性研究中，MT组和非MT组分别纳入了89例和158例患者。两组均在卒中后3天内进行dCA测量。使用传递函数参数、相位差（PD）和增益来量化dCA。良好预后定义为90天时改良Rankin量表评分≤2分。侧支循环评分用于反映侧支循环储备能力。
MT与患侧和健侧更好的PD相关。在MT组中，患侧的PD是良好预后的独立预测因素（比值比[OR]0.927，95%置信区间[CI]0.885 - 0.970；p < 0.001）。预测患侧PD良好预后的受试者工作特征曲线下面积为0.759（95%CI，0.654 - 0.864；p < 0.001）。此外，良好的侧支循环与更好的PD独立相关。
MT在卒中急性期对dCA有积极影响。对于接受MT的患者，dCA是预测预后的可靠指标，可能是改善预后的干预靶点。
