山东第一医科大学(山东省医学科学院)学报2023年9月第44卷第9期JournalofShandongFirstMedicalUniversity&ShandongAcademyofMedicalSciences,September2023,Vol.44No.9急性缺血性脑卒中血管内治疗后恶性脑水肿的影响因素沈艳平李志超赵彦新山东第一医科大学附属中心医院神经内科,山东济南250013摘要:急性缺血性脑卒中的致残、致死率高。当急性大血管闭塞引起脑梗死时,血管内治疗可以快速地开通闭塞血管,实现缺血组织再灌注,以及时挽救缺血半暗带,改善患者预后。但有部分患者会在血管内治疗后发生恶性脑水肿,且死亡率高。为探讨急性缺血性脑卒中血管内治疗后恶性脑水肿的影响因素,本文从脑水肿的发病机制以及影像学标志物及时间窗、中性粒细胞计数、侧支循环、血糖水平、糖化血红蛋白、B型利钠肽对脑水肿的影响方面进行综述,探索脑水肿的早期临床干预方法,为临床治疗提供理论依据。关键词:急性缺血性脑卒中;血管内治疗;恶性脑水肿;影响因素doi:10.3969/j.issn.2097-0005.2023.09.012InfluentialfactorsofcerebraledemaafterintravasculartreatmentofacuteischemicstrokeSHENYanping,LIZhichao,ZHAOYanxinDepartmentofNeurology,AffiliatedCentralHospitalofShandongFirstMedicalUniversity,Jinan250013,ChinaAbstract:Acuteischemicstrokehashighdisabilityandlethality.Whenacutelargebloodvesselocclusioncausescerebralinfarction,endovasculartreatmentcanquicklyopentheoccludedvessels,realizeischemiatissuereperfusion,timelyrescueischemicpenumbra,andimprovetheprognosisofpatients.However,somepatientsstillhavemalignantcerebraledemaafterendovasculartreatment,andhaveahighmortalityrate.Toinvestigatetheinfluencingfactorsofmalignantcerebraledemaafterendovasculartreatmentofacuteischemicstroke,thepathogenesisofcerebraledema,theimagingmarkersandtheeffectsoftimewindow,neutrophilcount,collateralcirculation,bloodglucoselevel,glycosylatedhemoglobinandB-typenatriureticpeptideoncerebraledemaarereviewed,andexplorestheearlyclinicalinterventionmethodsareexploredtoprovidetheoreticalbasisforclinicaltreatment.Keywords:acuteischemicstroke;endovasculartreatment;malignantbrainedema;influencingfactors急性缺血性脑卒中(acuteischemicstroke,AIS)是各种原...