Risk Factors Analysis Of Cerebral Hyperperfusion Syndrome After Bridging Treatment Of Anterior Circulation Cerebral Infarction

Objectives:To investigate the risk factors of cerebral hyperperfusion syndrome(cerebral hyperperfusion syndrome,CHS)after bridging treatment of acute anterior circulatory cerebral infarction(intraarterial intervention on intravenous thrombolysis),so as to give corresponding interventions to prevent the occurrence or progression of CHS.Methods:A retrospective study of 532 patients with acute anterior circulatory cerebral infarction who were admitted to Cangzhou People's Hospital from June 2015 to June 2019 in accordance with the Chinese National Stroke Registration(CNSR)clinical diagnosis.All patients were treated by bridging treatment,and were divided into two groups according to the TCD and CTP scanning parameters and combined with clinical symptoms,the experimental group: CHS group(27),the control group: non-CHS group(505).One-factor comparison of baseline and clinical data between the two groups included variables with statistical differences in the multivariate logistic regression model and developed for high-risk factors corresponding preventive measures.Results:1 In the single factor analysis: the general clinical basic data of the two groups: age,gender,height,weight,smoking history,drinking history,hyperlipidemia history,stroke history,atrial fibrillation history,previous oral antiplatelet drug history,previous oral anticoagulant drug history,NIHSS score and so on,the difference was not statistically significant(P>0.05);Compared with the non CHS group,the incidence of CHS in the CHS group with hypertension,diabetes and hyperhomocysteinemia was significantly higher than that in the non CHS group,which was related to the occurrence of CHS,and the difference was statistically significant(P<0.05).2 The analysis of surgical data of the two groups showed that there was no statistically significant difference between the two groups in the location of diseased blood vessels,surgical methods,times of thrombectomy,and postoperative vascular recanalization(P>0.05).3 The results of multivariate logistic model analysis showed that hypertension(OR = 5.058,95% CI: 1.911-13.386,P<0.05),diabetes(OR = 3.863,95% CI: 1.552-9.617,P<0.05),hyperhomocysteinemia(OR = 4.746,95% CI: 2.043-11.021,P<0.05)were independent risk factors for CHS after anterior circulation cerebral infarction bridging therapy.Conclusions:Patients with anterior circulating cerebral infarction are more likely to have CHS after operation with hypertension,diabetes,hyperhomocysteinemia before and after operation: hypertension,diabetes,hyperhomocysteinemia are the independent risk factors for CHS in patients with anterior circulatory cerebral infarction after bridging therapy,clinical attention must be paid to it,and targeted intervention is helpful to reduce the incidence of CHS after operation,and then improve the prognosis.