不同时间窗支架取栓对前循环急性脑梗死患者的治疗效果分析

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Abstract Objective： To evaluate the therapeutic effect of stent thrombectomy at different time windows on patients with acute cerebral infarction in the anterior circulation. Methods： A total of 193 patients with acute cerebral infarction in the anterior circulation were chosen, who were admitted to the Department of Neurology of the First Affiliated Hospital of Hebei North University from January 2020 to December 2022. The patients were divided into ≤3.0 h group (n=75), 3.0～4.5 h group (n=48), and 46-60 h group (n=70) based on the time from onset to receiving stent thrombus removal treatment. The patients were treated with stent thrombectomy≤3.0 h, 3.0～4.5 h, and 4.6～6.0 h after onset, respectively. The National Institutes of Health Stroke Scale (NIHSS) and Alberta Stroke Program Early CT (ASPECT) Score were used to assess the severity of patient′s conditions before and 14 days after treatment. After 7 and 21 days of treatment, the patient′s cognitive function was evaluated by the Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment Scale (MoCA). The contents of IL-4, hypersensitive C-reactive protein (hs-CRP) and high mobility group box-1 protein (HMGB1) in serum were detected by ELISA before treatment and 3, 7 days after treatment. After 90 days of treatment, the prognosis of the patients was assessed by using the modified Rankin Scale (mRS). Results： After 14 days of treatment, compared with ≤3.0 h group, the NIHSS score in 3.0～4.5 h group and 4.6～6.0 h group significantly increased (P<0.05), while the ASPECT score greatly decreased (P<0.05). At 7 and 21 days after treatment, compared with ≤3.0 h group, the MMSE and MoCA scores in 3.0～4.5 h and 4.6～6.0 h groups were significantly reduced (P<0.05). At 3 and 7 days after treatment, compared with ≤30 h group, the IL-4, hs-CRP, and HMGB1 levels significantly increased in the 3.0-4.5h group and the 4.6～6.0 h group (P<0.05). After 90 days of treatment, compared with the ≤3.0 h group, the proportion of mRS≤2 points in the 3.0～4.5 h group and the 4.6～6.0 h group was significantly decreased (P<0.05), and there was no statistical significance between the 3.0～4.5 h group and the 4.6～6.0 h group (P>0.05). Conclusion： The earlier (≤3.0 h) stent thrombectomy performed in patients with acute cerebral infarction in the anterior circulation, the better the clinical efficacy and neurological function recovery.

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Received: 20 October 2023

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	SUN Yan
	KONG Weidan
	WANG Gang
	LIU Hongna

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SUN Yan,KONG Weidan,WANG Gang等.

The therapeutic effect of stent thrombectomy at different time windows on patients with acute cerebral infarction in the anterior circulation

[J]. Journal of Jiangsu University(Medicine Edition), 2024, 34(05): 428-432,455.

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http://zzs.ujs.edu.cn/xbyxb/EN/ OR http://zzs.ujs.edu.cn/xbyxb/EN/Y2024/V34/I05/428

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