Recanalisation of middle cerebral artery occlusion after intra-arterial thrombolysis: different recanalisation grading systems and clinical functional outcome
Recanalisation of middle cerebral artery occlusion after intra-arterial thrombolysis: different recanalisation grading systems and clinical functional outcome
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动脉内溶栓后大脑中动脉闭塞的再通：不同的再通分级系统和临床功能结果
DOI：
10.1136/jnnp.2004.055160
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发表时间：
2005
期刊：
影响因子：
--
通讯作者：
H. Mattle
中科院分区：
文献类型：
--
作者：
M. Arnold;K. Nedeltchev;L. Remonda;U. Fischer;C. Brekenfeld;B. Keserue;G. Schroth;H. Mattle
背景资料：动脉再通的不同分级系统从未在接受动脉内溶栓（IAT）治疗的大量卒中患者中进行过比较。研究方法：分析了147例大脑中动脉M1或M2段闭塞患者的临床和血管造影结果及结果。比较心肌梗死溶栓（TIMI）分级系统和Mori分级系统与临床结局的关系。结果：入院时NIHSS评分中位数为15分，从症状发作到IAT的平均时间为242分钟。3个月后，85名患者（58%）的结局良好（定义为改良兰金量表评分（mRS）≥ 2），44名患者（30%）的结局较差（mRS 3 - 5）; 18名患者（12%）死亡。17例患者（12%）的再通被分类为TIMI 0级，16例患者（11%）的TIMI 1级，83例患者（56%）的TIMI 2级，31例患者（21%）的TIMI 3级。17例患者（12%）显示Mori 0级再灌注，16例（11%）Mori 1级，37例（25%）Mori 2级，46例（31%）Mori 3级和31例（21%）Mori 4级。在TIMI和Mori分级系统中，动脉再通是良好临床结局的独立预测因素（p<0.0001）。当血管部分再通时，再灌注>50%的患者（Mori 3）的结局优于再灌注<50%的患者（Mori 2）（p = 0.008）。 结论：TIMI和Mori分级系统均有助于预测卒中和IAT后的结局。当再通是部分时，Mori分类在提供预后信息方面更精确。
Background: Different grading systems of arterial recanalisation have never been compared in large series of stroke patients treated with intra-arterial thrombolysis (IAT). Methods: Clinical and angiographic findings and outcome were analysed in 147 patients with M1 or M2 segment occlusion of the middle cerebral artery treated with IAT. Associations of the thrombolysis in myocardial infarction (TIMI) grading system and the Mori grading system with clinical outcome were compared. Results: The median NIHSS score on admission was 15 and the mean time from symptom onset to IAT was 242 minutes. After three months the outcome was favourable (defined as modified Rankin scale score (mRS) ⩽2) in 85 patients (58%) and poor (mRS 3 to 5) in 44 (30%); 18 patients (12%) were dead. Recanalisation was categorised as TIMI grade 0 in 17 patients (12%), TIMI 1 in 16 (11%), TIMI 2 in 83 (56%), and TIMI 3 in 31(21%). Seventeen patients (12%) showed Mori grade 0 reperfusion, 16 (11%) Mori 1, 37 (25%) Mori 2, 46 (31%) Mori 3, and 31 (21%) Mori 4. In both TIMI and Mori grading systems, reopening the artery was an independent predictor of a favourable clinical outcome (p<0.0001). When recanalisation was partial, outcome was better in patients with reperfusion >50% (Mori 3) than in those with reperfusion <50% (Mori 2) (p = 0.008). Conclusions: Both TIMI and Mori grading systems are useful for predicting outcome after stroke and IAT. When recanalisation is partial the Mori classification is more refined in giving prognostic information.
影响因子：
8.3
作者：
HACKE, W;ZEUMER, H;DELZOPPO, GJ
通讯作者：
DELZOPPO, GJ