| 张雯君,徐庶,李震铎,等.大脑中动脉搏动指数对急性前循环大血管闭塞性卒中机械取栓后发生无效再通的预测价值[J].安徽医药,2026,30(7):1408-1412. |
| 大脑中动脉搏动指数对急性前循环大血管闭塞性卒中机械取栓后发生无效再通的预测价值 |
| Predictive value of middle cerebral artery pulsatility index for futile recanalization after mechanical thrombectomy in acute anterior circulation large vessel occlusion |
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| DOI：10.3969/j.issn.1009-6469.2026.07.027 |
| 中文关键词: 脑梗死 大脑中动脉 搏动血流 机械取栓 经颅多普勒超声 无效再通 搏动指数 预测价值 |
| 英文关键词: Cerebral infarction Middle cerebral artery aneurysm Pulsatile flow Mechanical thrombectomy Transcranial dop-pler sonography Invalid reconnection Pulsatility index Predictive value |
| 基金项目:张家港市科技计划项目( ZKYL2349) |
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| 中文摘要: |
| 目的探索大脑中动脉搏动指数( PI)对急性前循环大血管闭塞导致的缺血性卒中病人机械取栓后发生无效再通的预测价值。方法回顾性分析 2020年 1月至 2023年 12月张家港市第一人民医院收治的急性前循环大血管闭塞取栓术后且血管成功再通的病人，随访病人 90 d的改良 Rankin量表( mRS)结局分为无效再通组( 90 d mRS>2分)和有效再通组( 90 d mRS≤2分)。术后 24 h内在床边常规进行经颅多普勒超声( TCD)检查，并记录病侧大脑中动脉的收缩期峰值流速( PSV)、舒张期峰值流速(EDV)搏动指数( PI)。两组间进行基线比较，单因素和多因素 logistic回归分析得出无效再通的独立危险因素，绘制受试者操作特征曲、线( ROC曲线)并计算曲线下面积( AUC)获得 PI最佳截距值，评估 PI对无效再通的预测价值。结果共纳入病人 106例，年龄( 61.85±13.13)岁，其中有效再通组 61例，，无效再通组 45例。比较发现两组间糖尿病、基线美国国立卫生研究院卒中量表( NIHSS)、基线 Alberta卒中项目早期 CT评分( ASPECTS)等差异有统计学意义( P<0.05)无效再通组 PI值较有效再通组升高( 1.04比 0.80，P<0.001)。多因素 logistic回归分析发现 PI值和 ASPECTS评分是无效再通的独，立危险因素。 ROC曲线分析显示， PI值预测无效再通的 AUC为 0.84(P<0.001)最佳截断值为 0.96，此截断值预测的灵敏度为 71.1%，特异度为 91.8%。结论大脑中动脉搏动指数 PI值升高是前循环大血管闭，塞取栓后发生无效再通的独立危险因素。 |
| 英文摘要: |
| Objective To explore the predictive value of pulsatility index (PI) for futile recanalization in patients with ischemic strokecaused by acute anterior circulation large vessel occlusion after mechanical thrombectomy.Methods The patients with successful re.canalization after thrombectomy for acute anterior circulation large vessel occlusion admitted to the Zhangjiagang First People's Hospi-tal from January 2020 to December 2023 were retrospectively analyzed. The 90 day modified Rankin scale (mRS) score of the patientswas followed up. The outcome was divided into the futile recanalization group (90 day mRS>2 points) and the effective recanalizationgroup (90 day mRS ≤ 2 points). Transcranial Doppler (TCD) was performed routinely at the bedside within 24 hours after operation, andpeak systolic velocity (PSV), end diastolic velocity (EDV), PI values of the diseased middle cerebral artery were recorded. The indepen-dent risk factors of futile recanalization were obtained by univariate and multivariate logistic regression analysis. The receiver operatingcharacteristic curve (ROC curve) was drawn and the area under the curve (AUC) was calculated to obtain the optimal cutoff value of PI,and the predictive value of PI for futile recanalization was evaluated.Results A total of 106 patients with an average age of (61.85±13.13) years were included, including 61 cases in the effective recanalization group and 45 cases in the futile recanalization group.There were statistically significant differences in diabetes mellitus, baseline National Institutes of Health Stroke Scale (NIHSS) score,baseline Alberta stroke program early CT score (ASPECTS) between the two groups (P<0.05). The PI value in the futile recanalization group was higher than that in the effective recanalization group (1.04 vs. 0.80, P<0.001). Multivariate logistic regression analysis foundthat PI value and ASPECTS score were independent risk factors for futile recanalization. ROC curve analysis showed that the AUC ofPI value for predicting futile recanalization was 0.84 (P<0.001), and the optimal cutoff value was 0.96. The sensitivity and specificity ofthis cutoff value for predicting futile recanalization were 71.1% and 91.8%, respectively.Conclusion The elevated PI value of middle cerebral artery is an independent risk factor for futile recanalization after thrombectomy in anterior circulation large vessel occlusion. |
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