昼夜节律变化对血管内治疗患者成功康复后功能依赖性的影响

Meng Ke Zhang, Xian Wang, Xi Chen, Jiali Xu, Wenting Guo, Chang Hong Ren, Sijie Li, Wen Bo Zhao, Chuanjie Wu, Xunming Ji
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引用次数: 0

摘要

背景:越来越多的证据表明,昼夜节律生物学可能会影响中风的生理病理机制、进展和恢复。然而,关于血管内治疗(EVT)患者徒劳再通畅(FR)的昼夜节律数据却很少:从 2017 年到 2021 年,对接受 EVT 的大血管闭塞(LVO)急性缺血性卒中(AIS)患者进行了观察性队列研究。FR被定义为患者在EVT术后90天未能实现功能独立,尽管闭塞血管达到了再通畅。采用逻辑回归模型研究了昼夜节律对FR的影响:结果:在 783 名患者中,有 149 名患者在 23:00-6:59 之间发病,318 名患者在 7:00-14:59 之间发病,316 名患者在 15:00-22:59 之间发病。15:00-22:59期间发生中风的患者的OTP(P =0.001)时间较短、OTR(P =0.001)时间较短:昼夜节律可直接或间接影响 AIS 的发生、发展和预后。未来可能需要更多的研究来验证我们的研究结果,并探索昼夜节律对 FR 影响背后的潜在机制。
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Role of Circadian Rhythm Changes on Functional Dependence Despite Successful Repercussion in Patients with Endovascular Treatment.

Background: Increasing evidence of circadian biology may influence the physiopathologic mechanism, progression, and recovery of stroke. However, few data have shown about circadian rhythm on futile recanalization (FR) in patients treated with endovascular treatment (EVT).

Methods: From 2017 to 2021, an observational cohort of acute ischemic stroke (AIS) patients with large vessel occlusion (LVO) underwent EVT was conducted. FR was defined as the failure to achieve functional independence in patients at 90 days after EVT, although the occluded vessels reached a recanalization. The effect of circadian rhythm on FR was investigated using the logistic regression model.

Results: Of 783 patients, there were 149 patients who had stroke onset between 23:00-6:59, 318 patients between 7:00-14:59, and 316 patients between 15:00-22:59. Patients suffered a stroke during 15:00-22:59 had shorter OTP (p =0.001) time, shorter OTR (p<0.001) time, higher rate of intravenous thrombolysis (p =0.001) than groups of other time intervals. The rate of FR post-EVT in patients who had a stroke between 15:00-22:59 was significantly higher than in those with stroke onset between 23:00-6:59 (p =0.017). After adjusting for confounding factors, the time of stroke occurring during 15:00-22:59 (adjusted OR [aOR], 1.652; 95%CI, 1.024-2.666, p =0.04) was an independent predictor of FR.

Conclusion: Circadian rhythm can directly or indirectly affect the occurrence, development, and prognosis of AIS. More studies may be needed in the future to validate the results of our study and to explore the potential mechanisms behind the effects of circadian rhythms on FR.

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