【摘要】 目的 评估脑梗死进展速度对急性前循环缺血性脑卒中患者机械取栓术后发生症状性颅内出血(sICH)的影响。方法 回顾性分析2016年6月至2022年12月在苏州大学附属第一医院接受机械取栓治疗的急性缺血性脑卒中患者的临床资料，依照海德堡标准定义，将其分为取栓术后sICH组与无sICH组。比较两组患者临床及影像学资料，多因素logistic回归分析取栓术后发生sICH的独立危险因素，以受试者工作特征曲线下面积(AUC)评估梗死进展速度预测sICH的效能。结果 218例患者中，sICH组23例，无sICH组195例，两组患者NIHSS评分、侧支循环状态、核心梗死体积及梗死进展速度比较差异均有统计学意义(均P<0.05)。多因素logistic回归分析显示，梗死进展速度较快是机械取栓术后发生sICH的独立危险因素。梗死进展速度预测sICH的灵敏度为78.3%,特异度为69.7%,AUC=0.751,预测值为7.6 mL/h。结论 梗死进展速度较快是急性前循环缺血性脑卒中患者机械取栓后发生sICH的预测因子。梗死进展速度大于7.6 mL/h时，机械取栓后发生sICH的风险较高。更多还原

【Abstract】 Objective To evaluate the impact of the growth speed of cerebral infarction on the occurrence of symptomatic intracranial hemorrhage(sICH) in patients with acute anterior circulation ischemic stroke after mechanical thrombectomy.Methods The clinical data of patients with acute ischemic stroke(AIS),who received mechanical thrombectomy at the First Affiliated Hospital of Soochow University of China from June 2016 to December 2022,were retrospectively analyzed.After thrombectomy, the patients were divided into sICH group and non-sICH group according to Heidelberg criteria.The clinical data and imaging findings were compared between the two groups.Multivariate logistic regression analysis was used to identify the independent risk factors for sICH after thrombectomy, and the area under the receiver operating characteristic curve(AUC) was used to evaluate the efficacy of the growth speed of cerebral infarction in predicting sICH.Results A total of 218 patients were enrolled in this study, sICH group had 23 patients and non-sICH group had 195 patients.The differences in NIHSS score, collateral circulation status, core infarction volume, and growth speed of cerebral infarction between the two groups were statistically significant(all P<0.05).Multivariate logistic regression analysis showed that rapid growth speed of cerebral infarction was an independent risk factor for sICH occurring after mechanical thrombectomy.For predicting sICH,the sensitivity and specificity of the growth speed of cerebral infarction were 78.3% and 69.7% respectively, with an AUC of 0.751 and a predicted value of 7.6 mL/h.Conclusion The rapid growth speed of cerebral infarction is a predictive factor for sICH occurring after mechanical thrombectomy in patients with acute anterior circulation ischemic stroke.The risk of sICH becomes higher after mechanical thrombectomy when the growth speed of cerebral infarction is faster than 7.6 mL/h.更多还原