Efficacy Evaluationof Mechanical Thrombectomy On Acute Anterior Circulation Cerebral Infarction And The Correlation Between NADPH Oxidase P22phox And Hyperperfusion Syndrome

Objective:To observe the clinical effect of mechanical thrombectomy with Solitaire FR stent in patients with acute anterior circulation cerebral infarction,and to explore the correlation between NADPH oxidase p22 phox and hyperperfusion syndrome after thrombectomy.Methods: From January 2016 to January 2020,190 patients with acute anterior circulation cerebral infarction accepting mechanical thrombectomy(MT)in the stroke center of Linyi central hospital were selected as the study objects.Their sex,age,smoking,drinking,hypertension,diabetes,atrial fibrillation and other complications were recorded.TG,TC,HDL,LDLwere measured.The vascular recanalization of the patients were recorded and evaluateand by TICI(Thrombolysis in Cerebral Ischemia Scale).The occurrence of postoperative complications such as symptomatic cerebral hemorrhage,cerebral vasospasm,secondary cerebral embolism and high perfusion syndrome were recorded at the same time.The NIHSS scores of all patients who received MT with Solitaire FR stent before operation,3 days after operation,1 week and 3 months after operation.12 patients with hyperperfusion syndrome were included in the Hyperperfusion group and 20 patients without hyperperfusion syndrome were included in the Control group.The levels of NADPH oxidase p22 phox m RNA and MDA were measured by RT-PCR and ELISA 24 hours after MT.The relationship between p22 phox m RNA of NADPH oxidase and hyperperfusion syndrome after MT of Solitaire FR stent was analyzed.Results: 1.After MT,there were 113 patients with blood flow TICI3,6 patients reached TICI 2a,37 patients reached TICI 2b,24 patients reached TICI 1,10 patients reached TICI 0.There were 150 cases of recanalization and the recanalization rate was 78.95%.NIHSS score decreased significantly 3 days after MT compared with that before treatment,and further decreased 7 days and 3 months after treatment.(P <0.05).There were 6 cases of symptomatic cerebral hemorrhage,15 cases of cerebral vasospasm,8 cases of secondary cerebral embolism,12 cases of hyperperfusion syndrome,2 cases of death,and complications rate was 21.6%.2.3 days after MT,NIHSS score of high perfusion group was higherr than that of control group,the difference was statistically significant(P < 0.05).4.The levels of p22 phox m RNA and MDA in the high perfusion group were significantly higher than those in the control group(P < 0.05).5.With the increase of p22 phox m RNA expression of NADPH oxidase,Δ vs(cm / s)increased gradually,which was positively correlated with each other,and the correlation coefficient test was statistically significant(r = 0.589,P < 0.05).Conclusions:1.The mechanical thrombectomy with the Solitaire FR stent for acute anterior circulation cerebral infarction has a high rate of recanalization of occluded vessels,less complications,and it is safe and effective.2.NADPH oxidase p22 phox has a good positive correlation with high perfusion after Solitaire FR thrombectomy,suggesting that it may participate in the occurrence of high perfusion syndrome after thrombectomy.