背景:这项研究的目的是确定可以预测血管内治疗(EVT)前后出血性转化(HT)风险的血清生化标志物。
方法:本研究包括在2017年9月至2022年9月期间出现症状6小时内接受EVT的前循环大血管闭塞(ACLVO)患者。将这些患者回顾性地分为两组:HT组和无HT组。
结果:共180名患者被纳入研究,其中55人(30.6%)患有HT。EVT前单核细胞计数(p=0.005,OR=0.694,95%CI0.536-0.898),EVT前活化部分凝血活酶时间(p=0.009,OR=0.186,95%CI0.699-0.952),EVT后嗜酸性粒细胞计数(p=0.038,OR=0.001,95%CI0.000-0.018)均为HT的独立预测因子,警告值为6.65%,22.95秒,和0.035*10^9/L,分别。与仅使用人口统计数据的预测相比[AUC=0.662,95%CI(0.545,0.780)],在EVT之前添加生化指标[AUC=0.719,95%CI(0.617,0.821)],EVT后添加生化指标[AUC=0.670,95%CI(0.566,0.773)],并添加两个[AUC=0.778,95%CI(0.686,0.870)],在所有三种组合中,HT的预测效率都得到了提高,没有统计学意义。
结论:ACLVO患者EVT前后血清生化指标水平均有显著变化。人口统计学数据和血清生化标志物的组合被证明可有效预测接受EVT的ACLVO患者中HT的发生。
BACKGROUND: The aim of this
study was to determine the serum biochemical markers that can predict the risk of haemorrhagic transformation (HT) before and after endovascular treatment (EVT).
METHODS: This
study included patients with anterior circulation large vessel occlusion (ACLVO) who underwent EVT within six hours of symptom onset between September 2017 and September 2022. These patients were retrospectively categorised into two groups: an HT group and a No-HT group.
RESULTS: A total of 180 patients were included in the
study, of whom 55 (30.6%) had HT. The monocyte count before EVT (p = = 0.005, OR = 0.694, 95% CI 0.536-0.898), the activated partial thromboplastin time before EVT (p = 0.009, OR = 0.186, 95% CI 0.699-0.952), and the eosinophil count after EVT (p = 0.038, OR = 0.001, 95% CI 0.000-0.018) were all found to be independent predictors of HT, with warning values of 6.65%, 22.95 seconds, and 0.035*10^9/L, respectively. When compared to prediction using only demographic data [AUC = 0.662,95% CI (0.545, 0.780)], adding biochemical indices before EVT [AUC = 0.719,95% CI (0.617, 0.821)], adding biochemical indices after EVT [AUC = 0.670,95% CI (0.566, 0.773)], and adding both [AUC = 0.778,95% CI (0.686, 0.870)], the prediction efficiency of HT was improved among all three combinations, with no statistical significance.
CONCLUSIONS: The levels of serum biochemical markers were found to show significant changes before and after EVT in ACLVO patients. A combination of demographic data and serum biochemical markers proved to be effective in predicting the occurrence of HT in patients with ACLVO who underwent EVT.