机械血栓切除术治疗血小板减少症患者急性缺血性中风的安全性。

Sujie Zheng, Fang Liu, Liang Yu, Xinzhao Jiang, Xiaoyan Wen, Xu Wang, Zongjie Shi
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引用次数: 0

摘要

背景和目的:接受机械血栓切除术(MT)的急性缺血性卒中(AIS)患者中,血小板计数低对预后的影响尚不明确。在本研究中,我们进一步探讨了血小板减少对前循环大血管闭塞(LVO)卒中患者接受机械取栓术的安全性和有效性的影响:研究对象为2015年6月至2021年11月期间在本中心接受MT治疗的AIS患者。根据入院时记录的血小板计数,将患者分为两组:血小板减少组(结果:302 例患者中,有 1 例血小板减少,1 例血小板减少,1 例血小板减少,1 例血小板减少,1 例血小板减少在纳入研究的 302 例患者中,111 例(36.8%)发现血小板减少。单变量分析显示,血小板减少患者的年龄、心房颤动比例、sICH发生率、90天不良预后和死亡率均较高(均为p <;0.05)。多变量分析显示,血小板减少与较高的 sICH 发生率独立相关(OR 2.022,95% CI 1.074-3.807,p =0.029),但血小板减少并不影响 90 天功能预后(OR 1.045,95% CI 0.490-2.230,p =0.909)和死亡率(OR 1.389,95% CI 0.467-4.130 p =0.554):结论:血小板减少可能会增加接受 MT 治疗的 AIS 患者发生 sICH 的风险,但不会影响 90 天的功能预后和死亡率。
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Safety of Mechanical Thrombectomy for Acute Ischemic Stroke in Patients with Thrombocytopenia.

Background and aim: The impact of low platelet count on outcomes in patients with Acute Ischemic Stroke (AIS) undergoing Mechanical Thrombectomy (MT) is still unclear. In this study we have further explored the effect of thrombocytopenia on the safety and efficacy of MT in patients with anterior circulation Large Vessel Occlusion (LVO) stroke.

Materials and methods: Patients with AIS who underwent MT at our center between June 2015 and November 2021 were examined. Based on the platelet count recorded on admission patients were divided into two groups: those with thrombocytopenia (<150 × 109/L) and those without thrombocytopenia (≥ 150 × 109/L). Symptomatic Intracranial Hemorrhage (sICH) was the primary safety outcome. The efficacy outcome was functional independence defined as a 90-day modified Rankin Scale (mRS) score of 0-2. Multivariate logistic regression models were used to determine the risk factors for post-procedure sICH and 90-day functional outcomes.

Results: Among 302 patients included in the study, thrombocytopenia was detected in 111 (36.8%) cases. Univariate analysis showed age, the proportion of atrial fibrillation, the rates of sICH, 90-day poor outcomes, and mortality to be higher in patients with thrombocytopenia (all p <0.05). Multivariable analysis showed thrombocytopenia to be independently associated with a higher rate of sICH (OR 2.022, 95% CI 1.074-3.807, p =0.029) however, thrombocytopenia did not affect the 90-day functional outcomes (OR 1.045, 95%CI 0.490-2.230, p =0.909) and mortality (OR 1.389, 95% CI 0.467- 4.130 p = 0.554).

Conclusion: Thrombocytopenia may increase the risk of sICH but not affect the 90-day functional outcomes and mortality in patients with AIS treated with MT.

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