急性脑梗死患者介入术后预后相关因素的单中心回顾性研究

A Single-Center Retrospective Study of Factors Associated with the Prognosis of Patients with Acute Ischemic Stroke after In-terventional Therapy

摘要: 目的：探讨影响AIS患者机械取栓及补救性支架置入预后的相关因素。方法：选取本中心2019年至2022年所有进行机械取栓及补救性支架治疗的AIS患者，根据术后90天mRS评分将患者分为预后良好组(mRS评分0~2分)及预后不良组(mRS评分3~6分)。收集患者人口学特征、既往病史、入院时SII、术后24小时SII差值、肝肾功、OPT、入院时NIHSS评分、术后90天的mRS评分等临床资料；比较两组的资料有无统计学差异；使用多因素二元logistics回归分析影响AIS患者预后的独立危险因素；运用ROC曲线评估各独立危险因素对AIS患者预后的评估价值。结果：1) 入院NIHSS评分、OPT、取栓次数、LDH、SII差值是AIS患者介入术后预后的危险因素(OR > 1, P < 0.05)；2) ROC曲线分析表明各独立危险因素联合预测预后不良的准确性比单用NIHSS效果更佳(P < 0.05)。结论：1) 入院NIHSS评分、发病至股动脉穿刺时间、取栓次数、乳酸脱氢酶、术后24小时SII差值是影响AIS患者介入术后预后的独立危险因素；2) 各独立危险因素联合预测预后具有更优的预测效能。

Abstract: Objective: This study examines the factors associated with the prognosis of patients with AIS after interventional therapy. Methods: All AIS patients who underwent mechanical thrombectomy and remedial stenting in our center from 2019 to 2022 were selected, and patients were divided into good prognosis group (mRS score 0~2) and poor prognosis group (mRS score 3~6) according to their 90-day postoperative mRS score; patient data include demographic characteristics, past med-ical history, SII at admission, 24-hour postoperative SII. The clinical data including demographic characteristics, past medical history, SII at admission, SII at 24 hours postoperatively, difference, liver and kidney function, OPT, NIHSS score at admission, and mRS score at 90 days postoperatively were collected; whether there was a statistical difference between the data collected in the two groups was compared; the independent risk factors affecting the prognosis of AIS patients were an-alyzed by using multifactorial binary logistic regression; the value of each independent risk factor in assessing the prognosis of AIS patients was assessed by using ROC curves. Results: 1) Admission NIHSS score, OPT, number of mechanical bolus retrievals, LDH, and SII difference were risk factors affecting the prognosis of patients with AIS undergoing interventional therapy (OR > 1, P < 0.05); 2) ROC curve analysis showed that the combination of independent risk factors was better than NIHSS score alone in predicting the accuracy of poor prognosis in patients with AIS (P < 0.05). Conclusion: 1) Admission NIHSS score, time from onset to femoral artery puncture, number of mechanical bolus retrievals, lactate dehydrogenase, and 24-hour postoperative SII difference were independent risk factors affecting the prognosis of patients with AIS after intervention; 2) the combination of inde-pendent risk factors had superior predictive efficacy in predicting prognosis.