摘要目的:探讨接受桥接治疗(静脉溶栓合并血管内治疗)的急性基底动脉闭塞(BAO)患者预后的影响因素。方法:选择中国急性基底动脉闭塞血管内治疗多中心登记研究(ATTENTION)数据库中接受桥接治疗的404例急性BAO患者作为研究对象。收集患者的临床、影像学资料，治疗后90 d根据改良Rankin量表(mRS)评分评估患者的预后。比较预后良好、预后不良患者临床、影像学资料的差异，采用多因素Logistic回归分析确定患者预后的独立影响因素。结果:404例急性BAO患者中预后良好156(39%)例，预后不良248(61%)例。与预后良好组比较，预后不良组患者年龄>65岁、入院NIHSS评分>20分、取栓次数>1次者所占比例较高，血管成功再通者所占比例较低，闭塞部位的分布不同，差异均有统计学意义( P<0.05)。多因素Logistic回归分析结果显示入院NIHSS评分>20分( OR=0.510， 95%CI：0.331~0.786， P=0.002)、闭塞部位为远段基底动脉( OR=2.241， 95%CI：1.357~3.702， P=0.002)、取栓次数>1次( OR=0.523， 95%CI：0.339~0.807， P=0.003)以及血管成功再通( OR=2.022， 95%CI：1.032~3.961， P=0.040)是接受桥接治疗的急性BAO患者良好预后的独立影响因素。 结论:入院NIHSS评分>20分、非远段基底动脉闭塞、取栓次数>1次以及血管未成功再通的行桥接治疗后急性基底动脉闭塞患者预后不良。

abstractsObjective:To investigate the influencing factors for prognoses of patients with acute basilar artery occlusion (BAO) receiving bridging therapy (intravenous thrombolysis [IVT] combined with endovascular treatment [EVT]).Methods:The clinical and imaging data of 404 patients with acute BAO accepted bridging therapy were collected from Endovascular Treatment for acute Basilar Artery Occlusion (ATTENTION) database. The prognoses of these patients were evaluated by modified Rankin Scale (mRS) 90 d after treatment. The differences of clinical and imaging data between patients with good prognosis and poor prognosis were compared, and the independent influencing factors for prognoses were analyzed by multivariate Logistic regression.Results:Among 404 patients with acute BAO, 156 (39%) had good prognosis and 248 (61%) had poor prognosis. Compared with the good prognosis group, the poor prognosis group had significantly higher proportions of patients older than 65 years, patients with NIHSS scores>20 on admission, and patients with thrombectomy frequency>1, significantly lower proportion of patients with successful vascular recanalization, and significantly different distribution of occlusive sites ( P<0.05). Multivariate Logistic regression analysis showed that NIHSS scores on admission>20 ( OR=0.510, 95%CI: 0.331-0.786, P=0.002), and occlusion site at the distal basilar artery ( OR=2.241, 95%CI: 1.357-3.702, P=0.002), thrombectomy frequency>1 ( OR=0.523, 95%CI: 0.339-0.807, P=0.003) and successful vascular recanalization ( OR=2.022, 95%CI: 1.032-3.961, P=0.040) were independent influencing factors for good prognosis of these patients. Conclusion:Acute BAO patients with NIHSS scores>20 on admission, thrombectomy frequency>1, non-distal BAO occlusion, and unsuccessful recanalization have poor prognosis after bridging therapy.