摘要目的:探索急性基底动脉闭塞血管内治疗成功再通后90 d的不良临床结局的发生率和相关因素。方法:本研究的研究人群来自一项于2015年6月至2017年12月的多中心、前瞻性、登记研究：血管内治疗急性缺血性脑卒中协作组（ANGEL）登记研究。收集患者的人口统计学特征，既往史，个人史，生命体征，美国国立卫生研究院卒中量表（NIHSS）评分，影像学检查，发病/入院/穿刺/手术结束时间点，手术相关变量，术中用药情况，术毕闭塞血管开通情况，病因分型，90 d改良Rankin量表（mRS）评分。血管内治疗术毕成功再通的定义为改良脑梗死溶栓（mTICI）分级2b~3级，不良临床结局定义为患者90 d mRS评分4~6分。多因素logistic回归模型分析来确定不良临床结局的相关因素。结果:170例接受血管内治疗且成功再通的急性基底动脉闭塞患者纳入本研究，男性128例，女性42例，年龄［ M（ Q1， Q3）］64（55，70）岁。其中72例患者（42.4%）发生了不良临床结局，98例患者（57.6%）发生了良好临床结局。多因素logistic回归模型分析结果显示，高基线NIHSS评分（ OR=1.166，95% CI：1.109~1.225， P<0.001）和高术前收缩压（ OR=1.032，95% CI：1.010~1.053， P=0.003）是不良临床结局的相关影响因素。 结论:急性基底动脉血管内治疗成功再通后90 d不良临床结局的发生率为42.4%，高基线NIHSS评分和高术前收缩压与不良临床结局相关。

abstractsObjective:To investigate the incidence and predictors of 90-day poor clinical outcome after successful endovascular treatment for acute basilar artery occlusion.Methods:Patients were selected from the Acute Ischemic Stroke Cooperation Group of Endovascular Treatment (ANGEL) registry, which was a prospective, multicenter registry study between June 2015 and December 2017. The demographic characteristics, past history, personal history, vital signs, National Institutes of Health Stroke Scale (NIHSS) score, imaging examination, onset/admission/puncture/end of operation, operation-related variables, medication during operation, patency of occluded blood vessels after operation, etiology classification, and 90-day modified Rankin scale (mRS) score were collected. Successful endovascular treatment was defined as modified thrombolysis in cerebral infarction (mTICI) 2b-3. Poor outcome was defined as 90-day mRS 4-6. Multivariate logistic regression analysis was performed to analyze the predictors of poor clinical outcome after successful endovascular treatment.Results:A total of 170 (128 males and 42 females) acute basilar artery occlusion patients undergoing successful endovascular treatment were included in the analysis, with the median age of [ M ( Q1, Q3)] of 64 (55, 70) years. Poor clinical outcome occurred in 72 patients (42.4%). Multivariate logistic regression analysis revealed that high baseline NIHSS score ( OR=1.166, 95% CI: 1.109-1.225, P<0.001) and high baseline systolic blood pressure ( OR=1.032, 95% CI: 1.010-1.053, P=0.003) were the independent predictors of poor clinical outcome. Conclusions:The incidence of 90-day poor clinical outcome after successful endovascular treatment for acute basilar artery occlusion is 42.4%. High baseline NIHSS score and systolic blood pressure are associated with the poor clinical outcome.