急性前循环大血管闭塞性脑梗死进展速度的影响因素分析

doi:10.3969/j.issn.1006-7795.2025.04.016

首都医科大学学报 ›› 2025, Vol. 46 ›› Issue (4): 688-693.doi: 10.3969/j.issn.1006-7795.2025.04.016

急性前循环大血管闭塞性脑梗死进展速度的影响因素分析

张潇文^1#,唐涛^1#,李迪²,李深¹,席春江^1*

1. 首都医科大学附属北京世纪坛医院神经与精神科，北京100038；2. 大连理工大学附属中心医院神经介入科，辽宁大连116024

收稿日期:2024-09-30 出版日期:2025-08-21 发布日期:2025-09-01
通讯作者: 席春江 E-mail:xichunjiang@163.com
基金资助:
国家自然科学基金项目(82371298, 82311530048)，首都卫生发展科研专项项目(2024-2-2086)，北京市科技计划课题项目(Z221100007422111)，首都医科大学附属北京世纪坛医院领军人才培养项目(2024LJRCLS)。

Analysis of the risk factors of the infarct growth rate in acute anterior circulation large vessel occlusion

Zhang Xiaowen^1#, Tang Tao^1#, Li Di², Li Shen¹, Xi Chunjiang^1*

1. Department of Neurology and Psychiatry, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China; 2. Department of Neurointervention, Central Hospital of Dalian University of Technology, Dalian 116024, Liaoning Province, China

Received:2024-09-30 Online:2025-08-21 Published:2025-09-01
Supported by:
This study was supported by National Natural Science Foundation of China (82371298, 82311530048), Capital's Funds for Health Improvement and Research (2024-2-2086), Beijing Municipal Science & Technology Commission (Z221100007422111), Leader Talent Training Program of Beijing Shijitan Hospital, Capital Medical University (2024LJRCLS).

摘要/Abstract

摘要： 目的探讨急性前循环大血管闭塞性脑梗死进展速度的影响因素。方法回顾性连续收集2021年9月至2023年7月大连理工大学附属中心医院收治的急性前循环大血管闭塞性脑梗死患者为研究对象。根据术前梗死进展速度中位数将患者平均分为快速进展组和缓慢进展组，每组各145例。通过单因素分析及多因素Logistic回归模型分析影响急性前循环大血管闭塞患者脑梗死进展速度的危险因素。结果经过单因素筛选，多因素Logistic回归分析显示，高血压(OR=2.27, 95% CI: 1.39~3.71)、心房颤动(OR=1.95, 95% CI: 1.22~3.12)、颈内动脉颅内段闭塞(OR=1.98, 95% CI: 1.19~3.28)是脑梗死快速进展的危险因素(P<0.05)。高血压、心房颤动、颈内动脉颅内段闭塞三项因素均有预测梗死进展速度的效能(P<0.05)，但效能较低。将三者串联联合预测梗死进展的曲线下面积为0.642 (0.579~0.704)，预测效能有所提升，但仍然较低。结论合并高血压、心房颤动和近端闭塞是急性前循环大血管闭塞性脑梗死快速进展的危险因素。

关键词: 前循环大血管闭塞, 脑梗死, 梗死进展速度, 危险因素, 高血压, 心房颤动, 颈内动脉闭塞

Abstract: Objective To investigate the risk factors of the infarct growth rate (IGR) in patients with acute anterior circulation large vessel occlusion. Methods This is a retrospective analysis of consecutive patients having acute anterior circulation large-vessel occlusion and being admitted to the Department of Neurointerventional Intervention, Central Hospital affiliated to Dalian University of Technology between September 2021 and July 2023. Patients were dichotomized into rapid and slow growth groups based on the median value of IGR, with 145 cases in each group. Univariate and multivariate Logistic regression models were used to analyze the risk factors of preoperative IGR. Results Multivariable Logistic regression analysis, after univariate screening, showed that hypertension (OR=2.27, 95% CI: 1.39-3.71), atrial fibrillation (OR=1.95, 95% CI: 1.22-3.12), and intracranial internal carotid artery occlusion (OR=1.98, 95% CI: 1.19-3.28) were risk factors of preoperative IGR (P<0.05). Hypertension, atrial fibrillation, and internal carotid artery occlusion all exhibited relatively low predictive value for IGR (P<0.05). The area under the curve for predicting IGR by combining these three factors was 0.642 (95% CI: 0.579-0.704), indicating a slight improvement in predictive performance, yet it remained relatively low. Conclusion Hypertension, atrial fibrillation, and proximal occlusion are risk factors of IGR in patients having acute anterior circulation large vessel occlusion.

Key words: large vessel occlusion, cerebral infarction, infarct growth rate, risk factor, hypertension, atrial fibrillation, internal carotid artery occlusion

中图分类号:

R543

张潇文, 唐涛, 李迪, 李深, 席春江. 急性前循环大血管闭塞性脑梗死进展速度的影响因素分析[J]. 首都医科大学学报, 2025, 46(4): 688-693.

Zhang Xiaowen, Tang Tao, Li Di, Li Shen, Xi Chunjiang. Analysis of the risk factors of the infarct growth rate in acute anterior circulation large vessel occlusion[J]. Journal of Capital Medical University, 2025, 46(4): 688-693.

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急性前循环大血管闭塞性脑梗死进展速度的影响因素分析

Analysis of the risk factors of the infarct growth rate in acute anterior circulation large vessel occlusion

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