mTICI 2b级与3级再灌注对急性缺血性脑卒中患者远期预后的影响

mTICI 2b级与3级再灌注对急性缺血性脑卒中患者远期预后的影响
周义锋^1） 刘 燕^1） 罗庆明^1） 李 晶^2） 
1）安徽医科大学附属滁州医院（滁州市第一人民医院），安徽 滁州 239000 2）泰州市第四人民医院，江苏 泰州 225300
通信作者：周义锋
【摘要】 目的 探讨改良脑梗死溶栓（mTICI）评分 2b 级与 mTICI 3 级再灌注对急性缺血性脑卒中（AIS）患者远期预后的影响。方法 纳入 2019-06—2021-06 安徽医科大学附属滁州医院收治的 AIS 患者 80 例，根据血管内治疗（EVT）后 mTICI 再灌注程度分为 A 组和 B 组，A 组为 30 例 mTICI 2b 级再灌注AIS 患者，B 组为 50 例 mTICI 3 级再灌注 AIS 患者。比较 2 组患者治疗后 1 d 梗死灶体积变化、责任血管再闭塞率、出血转化率、美国国立卫生研究院卒中量表（NIHSS）评分、病死率及症状性颅内出血（sICH）发生率，采用改良 Rankin 量表（mRS）评估 2 组患者预后情况。结果 治疗后 6 个月，2 组患者术后梗死灶体积、责任血管再闭塞率、出血转化率、sICH、病死率及预后良好率比较，均无统计学差异（P>0.05）；治疗后 1 周、3 个月及 6 个月，2 组患者 NIHSS 评分较之前均降低，且同时间段 B 组 NIHSS 评分均低于 A 组（P<0.05）。结论 mTICI 2b 级与 mTICI 3 级再灌注 AIS 患者均能取得较好疗效及预后，但 mTICI 3 级再灌注 AIS 患者的神经功能恢复更好，预后结局更佳。
【关键词】 血管内治疗；急性缺血性脑卒中；再灌注；预后；改良脑梗死溶栓评分
【中图分类号】 R743.3 【文献标识码】 A 【文章编号】 1673-5110 （2022） 07-0819-06
基金项目：2020 年安徽理工大学校级资助项目（编号：fsyyyb2020-05）
DOI：10.12083/SYSJ.220692
 
Effect of mTICI grade 2b and 3 reperfusion on the long-term prognosis of patients with acute ischemic stroke
ZHOU Yifeng^1） ，LIU Yan^1） ，LUO Qingming^1） ，LI Jing^2） 
1）Chuzhou Hospital Affiliated to Anhui Medical University/Chuzhou First People’s Hospital，Chuzhou 239000，China；
2）Taizhou Fourth People’s Hospital，Taizhou 225300 China
Corresponding author：ZHOU Yifeng
【Abstract】 Objective To investigate the effect of modified thrombolysis in cerebral infarction（mTICI）grade 2b and mTICI grade 3 reperfusion on the efficacy and long-term prognosis of patients with acute ischemic stroke（AIS）. Methods A total of 80 AIS patients admitted to Chuzhou Hospital Affiliated to Anhui Medical University from June 2019 to June 2021 were selected and divided into group A and group B according to the degree of mTICI reperfusion after endovascular therapy（EVT）. Group A consisted of 30 patients with mTICI grade 2b reperfusion AIS，and group B consisted of 50 patients with mTICI grade 3 reperfusion AIS. The changes in infarct volume，responsible vessel reocclusion rate，hemorrhagic transformation rate，National Institutes of Health stroke scale （NIHSS） score，fatality rate and incidence of symptomatic intracranial hemorrhage （sICH） were compared between the two groups at 1 day after treatment. The Rankin scale（mRS）was used to evaluate the prognosis of the two groups of patients. Results Six months after treatment，there were no significant differences in postoperative infarct volume，responsible vessel reocclusion rate，hemorrhagic transformation rate，sICH，fatality rate and good prognosis rate between the two groups（P>0.05）. At 1 week，3 months and 6 months after treatment，the NIHSS scores of both groups were lower than before，and the NIHSS scores of group B were lower than those of group A at the same time period（P<0.05）. Conclusion AIS patients with TICI grade 2b and TICI grade 3 reperfusion can achieve better curative effect and prognosis，but mTICI grade 3 reperfusion AIS patients have better neurological function recovery
，which is more conducive to the prognosis of patients.
【Key words】Endovascular therapy；Acute ischemic stroke；Reperfusion；Prognosis；Modified thrombolysis in cerebral infarction score