【摘要】 目的 分析再灌注治疗对低美国国立卫生研究院卒中量表（NIHSS）评分的前循环大血管闭塞（LVO）急性缺血性脑卒中的疗效。方法 选择2016年1月至2022年1月宁波市医疗中心李惠利医院卒中中心接诊的NIHSS评分<6分的前循环LVO急性缺血性脑卒中患者130例。起病24 h内行再灌注治疗的82例为观察组（其中立即再灌注亚组61例，延迟再灌注亚组21例），48例未行再灌注治疗的为对照组。比较两组患者一般资料、NIHSS评分变化、出血转化、症状性颅内出血、非症状性颅内出血发生率及90 d预后结果，比较即刻和延迟再灌注治疗对预后的影响。采用多因素logistic回归分析低NIHSS评分的前循环LVO急性缺血性脑卒中患者预后的影响因素。结果 观察组患者症状出现到入院时间低于对照组，90 d时预后良好率高于对照组，差异均有统计学意义（均P<0.05）。两组患者NIHSS评分变化比较，差异有统计学意义（P<0.05），出血转化、症状性颅内出血、非症状性颅内出血发生率及90 d病死率比较，差异均无统计学意义（均P>0.05）。立即再灌注亚组再灌注前NIHSS评分低于延迟再灌注亚组，90 d时预后良好率高于延迟再灌注亚组，差异均有统计学意义（均P<0.05）。多因素logistic回归分析结果显示，再灌注和症状出现到入院时间是低NIHSS评分的前循环LVO急性缺血性脑卒中患者预后的影响因素。结论 即刻再灌注治疗有利于改善低NIHSS评分的前循环LVO急性缺血性脑卒中患者的预后。更多还原

【Abstract】 Objective To analyze the efficacy of reperfusion therapy on patients with anterior circulation large vessel occlusion(LVO) stroke and low National Institutes of Health stroke scale(NIHSS) score. Methods A total of 130patients with anterior circulation LVO stroke and NIHSS score <6 were enrolled in Stroke Center of Ningbo Medical Center Lihuili Hospital from January 2016 to January 2022, 82 cases(observation group) underwent reperfusion treatment and 48 cases(control group) did not within 24 hours of onset. Immediate and delayed reperfusion was performed in 61cases and 21 cases, respectively. General data, NIHSS score, hemorrhage transformation, symptomatic and non-symptomatic intracranial hemorrhage, and 90-day outcome were compared between the two groups. The prognosis was compared between patients with immediate and delayed reperfusion. Multivariate logistic regression was used to analyze factors influencing prognosis of patients with LVO stroke and low NIHSS score. Results The time from symptom occurrence to admission was significantly lower in the observation group than in the control group(P<0.05).The 90-day good outcome rate was significantly higher in the observation group than in the control group(P<0.05).There were statistically significant differences in changes of NIHSS score between the two groups(P < 0. 05). The incidence of hemorrhage transformation, symptomatic intracranial hemorrhage, non-symptomatic intracranial hemorrhage and 90-day mortality were not significantly different between the two groups. Patients treated with immediate reperfusion had significantly lower NIHSS score and higher 90-day good outcome rate than patients treated with delayed reperfusion(all P<0.05). Multivariate logistic regression analysis showed that reperfusion and the time from symptom occurrence to hospital admission were prognostic factors for anterior circulation LVO patients with low NIHSS score. Conclusion Immediate reperfusion therapy may improve prognosis of patients with anterior circulation LVO stroke and low NIHSS score.更多还原