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前循环大血管闭塞所致低NIHSS评分急性脑梗死介入再通的疗效与安全性及无效再通相关因素探讨

Effect and safety of interventional recanalization in acute cerebral infarction with low NIHSS score due to anterior circulation large vessel occlusion and exploration of factors associated with futile recanalization.

作者信息

Zhang Wensheng, Xing Weifang, Wen Yangchun, Zhong Xiaojing, He Jinzhao

机构信息

Heyuan People's Hospital, Guangdong Provincial People's Hospital Heyuan Hospital, Heyuan, China.

Heyuan Key Laboratory of Molecular Diagnosis and Disease Prevention and Treatment, Doctors Station of Guangdong Province, Heyuan People's Hospital, Heyuan, China.

出版信息

Front Neurol. 2025 Mar 7;16:1473306. doi: 10.3389/fneur.2025.1473306. eCollection 2025.

Abstract

OBJECTIVE

To explore the efficacy and safety of successful interventional recanalization in patients with low NIHSS score acute cerebral infarction due to anterior circulation large vessel occlusion and influencing factors of futile recanalization.

METHODS

A retrospective analysis was conducted on the clinical data of patients with acute cerebral infarction due to anterior circulation large vessel occlusion treated in our hospital from January 2019 to December 2023. Statistical methods such as chi square test, t-test and non parametric test for statistical analysis were used.

RESULTS

A total of 445 patients were included in the study, including 32 in the low NIHSS score group and 413 in the non low NIHSS score group. There were statistical differences in NIHSS score at onset, preoperative ASPECT score, collateral circulation score, pathogenesis, effective recanalization rate, futile recanalization rate and 3-month postoperative mRS score between the two groups. There was no statistical difference in the incidence of complications such as symptomatic cerebral hemorrhage between the two groups. There were statistically significant differences in preoperative ASPECT score and collateral circulation score in terms of factors affecting futile recanalization in patients with low NIHSS score.

CONCLUSION

Patients with acute cerebral infarction with anterior circulation large vessel occlusion and low NIHSS score had good therapeutic effect after successful interventional recanalization, and the safety was comparable to that of patients with non low NIHSS score. The factors that affecting futile recanalization in patients with low NIHSS score included preoperative ASPECT score and collateral circulation score.

摘要

目的

探讨前循环大血管闭塞所致美国国立卫生研究院卒中量表(NIHSS)评分低的急性脑梗死患者介入再通成功的疗效、安全性及再通失败的影响因素。

方法

回顾性分析2019年1月至2023年12月在我院治疗的前循环大血管闭塞所致急性脑梗死患者的临床资料。采用卡方检验、t检验和非参数检验等统计学方法进行统计分析。

结果

本研究共纳入445例患者,其中NIHSS评分低组32例,非NIHSS评分低组413例。两组在发病时NIHSS评分、术前ASPECT评分、侧支循环评分、发病机制、有效再通率、再通失败率及术后3个月改良Rankin量表(mRS)评分方面存在统计学差异。两组在症状性脑出血等并发症发生率方面无统计学差异。术前ASPECT评分和侧支循环评分在影响NIHSS评分低的患者再通失败因素方面存在统计学差异。

结论

前循环大血管闭塞且NIHSS评分低的急性脑梗死患者介入再通成功后治疗效果良好,安全性与非NIHSS评分低的患者相当。影响NIHSS评分低的患者再通失败的因素包括术前ASPECT评分和侧支循环评分。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3429/11925792/b3ae10014ad2/fneur-16-1473306-g001.jpg

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