{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T14:53:05Z","timestamp":1774536785637,"version":"3.50.1"},"reference-count":0,"publisher":"Ideggyogyaszati Szemle Journal","issue":"3-4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ideggy\u00f3gy\u00e1szati szemle"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:p>Bevezet\u00e9s\nA nagy\u00e9r-elz\u00e1r\u00f3d\u00e1s gyakran malignus arteria cerebri media infarktushoz vezet, aminek a standard kezel\u00e9se a mechanikus thrombectomia. Ugyanakkor a sikeres reperf\u00fazi\u00f3 ischaemia\/reperf\u00fazi\u00f3s k\u00e1rosod\u00e1st eredm\u00e9nyezhet, ami agyoedem\u00e1hoz vagy v\u00e9rz\u00e9ses transzform\u00e1ci\u00f3hoz vezethet. A dekompressz\u00edv craniectomia \u00e9letment\u0151 beavatkoz\u00e1s, amit az intracranialis hypertonia kezel\u00e9s\u00e9re \u00e9s az agyi herniatio megel\u0151z\u00e9s\u00e9re alkalmaznak. A leg\u00fajabb vizsg\u00e1latok szerint a m\u00e1jfibrosis n\u00f6velheti a stroke kock\u00e1zat\u00e1t, m\u00e9g a hagyom\u00e1nyos cardiovascularis rizik\u00f3faktorok figyelembev\u00e9tel\u00e9t k\u00f6vet\u0151en is. A fibrosis-4 (fib-4) index \u2013 a m\u00e1jfibrosis egyszer\u0171, nem invaz\u00edv markere, amit az \u00e9letkor, az aszpart\u00e1t-aminotranszfer\u00e1z (m\u00e1sn\u00e9ven glutam\u00e1t-ox\u00e1lacet\u00e1t-transzamin\u00e1z, ASAT), az alanin-aminotranszfer\u00e1z (glutam\u00e1t-piruv\u00e1ttranszamin\u00e1z, ALAT) \u00e9s a thrombocytasz\u00e1m alapj\u00e1n sz\u00e1m\u00edtanak \u2013 klinikai jelent\u0151s\u00e9ggel b\u00edrhat ebben az \u00f6sszef\u00fcgg\u00e9sben. A vizs\u00adg\u00e1\u00adlat c\u00e9lja annak meghat\u00e1roz\u00e1sa volt, hogy a felv\u00e9telkor m\u00e9rt fib-4 index el\u0151re jelezheti-e a dekompressz\u00edv craniectomia sz\u00fcks\u00e9gess\u00e9g\u00e9t nagy\u00e9r-elz\u00e1r\u00f3d\u00e1s miatti akut ischaemi\u00e1s stroke-ban szenved\u0151, mechanikus thrombectomi\u00e1n \u00e1tesett betegekn\u00e9l.\n\nM\u00f3dszerek\nEbbe a retrospekt\u00edv vizsg\u00e1latba olyan betegek ker\u00fcltek bevon\u00e1sra, akik 2022 janu\u00e1rja \u00e9s 2024 decembere k\u00f6z\u00f6tt mechanikus thrombectomi\u00e1n estek \u00e1t D\u00e9l- \u00e9s Kelet-T\u00f6r\u00f6korsz\u00e1g k\u00e9t stroke-k\u00f6zpontj\u00e1ban. A betegeket k\u00e9t csoportra osztott\u00e1k aszerint, hogy r\u00e9szes\u00fcltek-e dekompressz\u00edv craniectomi\u00e1ban. A fib-4 indexet a k\u00f6vetkez\u0151 k\u00e9plettel sz\u00e1m\u00edtott\u00e1k: (ASAT \u00d7 \u00e9letkor) \/ (thrombocytasz\u00e1m \u00d7 \u221aALAT).\n\nEredm\u00e9nyek\nA dekompressz\u00edv craniectomi\u00e1n \u00e1tesett betegek szignifik\u00e1nsan id\u0151sebbek voltak, magasabb National Institute of Health Stroke Scale-pontsz\u00e1mmal, magasabb m\u00f3dos\u00edtott Rankin-sk\u00e1la-\u00e9rt\u00e9kekkel, magasabb szisztol\u00e9s \u00e9s diasztol\u00e9s v\u00e9rnyom\u00e1ssal, magasabb fib-4 indexszel, valamint magasabb v\u00e9rz\u00e9ses transzform\u00e1ci\u00f3s ar\u00e1nnyal rendelkeztek. A ROC-g\u00f6rbe-elemz\u00e9s 1,24-es fib-4-k\u00fcsz\u00f6b\u00e9rt\u00e9ket azonos\u00edtott (g\u00f6rbe alatti ter\u00fclet: 0,85), ami 70%-os szenzitivit\u00e1ssal \u00e9s 93%-os specificit\u00e1ssal jelezte el\u0151re a dekompressz\u00edv m\u0171t\u00e9t sz\u00fcks\u00e9gess\u00e9g\u00e9t. A nem korrig\u00e1lt egyv\u00e1ltoz\u00f3s logisztikus regresszi\u00f3s anal\u00edzis azt mutatta, hogy a fib-4 index er\u0151s, f\u00fcggetlen prediktora a dekompressz\u00edv craniectomi\u00e1nak.\n\nK\u00f6vetkeztet\u00e9s\nA fib-4 index jelent\u0151s \u00e9s f\u00fcggetlen prognosztikai markernek bizonyult a mechanikus thrombectomi\u00e1t k\u00f6vet\u0151en dekompressz\u00edv m\u0171t\u00e9tre szorul\u00f3 akut ischaemi\u00e1s stroke-betegek azonos\u00edt\u00e1s\u00e1ban.<\/jats:p>","DOI":"10.18071\/isz.79.0093","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T13:58:41Z","timestamp":1774533521000},"page":"93-101","source":"Crossref","is-referenced-by-count":0,"title":["A fibrosis-4 index klinikai \u00e9rt\u00e9ke a dekompressz\u00edv craniectomia el\u0151rejelz\u00e9s\u00e9ben mechanikus thrombectomi\u00e1t k\u00f6vet\u0151en stroke eset\u00e9n"],"prefix":"10.18071","volume":"79","author":[{"given":"Fatma Ebru","family":"Ag\u00fcl","sequence":"first","affiliation":[{"name":"0000-0003-0318-7571"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Halil","family":"Ay","sequence":"additional","affiliation":[{"name":"0000-0001-7233-7698"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y\u00fcksel","family":"Kablan","sequence":"additional","affiliation":[{"name":"0000-0002-5581-2968"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"7411","published-online":{"date-parts":[[2026]]},"container-title":["Ideggy\u00f3gy\u00e1szati szemle"],"original-title":[],"link":[{"URL":"https:\/\/elitmed.hu\/en\/publications\/clinical-neuroscience\/clinical-value-of-the-fibrosis-4-index-in-predicting-decompressive-craniectomy-after-mechanical-thrombectomy-in-stroke\/pdf-open","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T13:58:42Z","timestamp":1774533522000},"score":1,"resource":{"primary":{"URL":"https:\/\/elitmed.hu\/en\/publications\/clinical-neuroscience\/clinical-value-of-the-fibrosis-4-index-in-predicting-decompressive-craniectomy-after-mechanical-thrombectomy-in-stroke"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":0,"journal-issue":{"issue":"3-4","published-online":{"date-parts":[[2026]]},"published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.18071\/isz.79.0093","relation":{},"ISSN":["0019-1442","2498-6208"],"issn-type":[{"value":"0019-1442","type":"print"},{"value":"2498-6208","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]}}}