CAJ | 학술논문

背景:英国牛津郡社区脑卒中项目(Oxfordshire Community Stroke Project,OCSP)是1991年在英国牛津社区进行脑卒中大规模调查基础上提出的脑梗死的新的分型方法,完全根据患者的临床表现而分型,不需要临床仪器的检查,而且准确的分型还可以预测患者病变的大小、部位和受累的血管.目的:了解脑梗死患者OCSP中Bamford的临床分型及其各型远期功能预后.设计:以患者为研究对象,观察对比、验证性研究.单位:一所大学医院的神经内科.对象:2001-01-01/12-31西安交通大学第一医院神经内科住院脑血管病患者126例,男82例,女44例.方法:采用Bamford的OCSP分型法,对126例住院脑梗死患者进行分型,并于出院时、出院3个月和6个月后应用Barthel指数(Barthelindex,BI)和改良Rankin量表评分(modify Rankin Scale,mRS)评估残疾程度.主要观察指标:脑梗死患者OCSP分型及其各型患者出院时,出院3,6个月时BI,mRS评分.结果:在126例脑梗死患者中,完全前循环梗死(TACI)8例(6.3%),部分前循环梗死(PACI)29例(23.0%),腔隙性梗死(LACI)78例(61.9%),后循环梗死(POCI)11例(8.7%);随访期间12例患者死亡,114例完成了6个月随访,TACI的预后最差,POCI和LACI预后相对较好,PACI次之.结论:脑梗死以LACI居多,OCSP分型可有效预测脑梗死患者远期预后功能.有必要进一步扩大样本进行多中心前瞻性研究.
배경:영국우진군사구뇌졸중항목(Oxfordshire Community Stroke Project,OCSP)시1991년재영국우진사구진행뇌졸중대규모조사기출상제출적뇌경사적신적분형방법,완전근거환자적림상표현이분형,불수요림상의기적검사,이차준학적분형환가이예측환자병변적대소、부위화수루적혈관.목적:료해뇌경사환자OCSP중Bamford적림상분형급기각형원기공능예후.설계:이환자위연구대상,관찰대비、험증성연구.단위:일소대학의원적신경내과.대상:2001-01-01/12-31서안교통대학제일의원신경내과주원뇌혈관병환자126례,남82례,녀44례.방법:채용Bamford적OCSP분형법,대126례주원뇌경사환자진행분형,병우출원시、출원3개월화6개월후응용Barthel지수(Barthelindex,BI)화개량Rankin량표평분(modify Rankin Scale,mRS)평고잔질정도.주요관찰지표:뇌경사환자OCSP분형급기각형환자출원시,출원3,6개월시BI,mRS평분.결과:재126례뇌경사환자중,완전전순배경사(TACI)8례(6.3%),부분전순배경사(PACI)29례(23.0%),강극성경사(LACI)78례(61.9%),후순배경사(POCI)11례(8.7%);수방기간12례환자사망,114례완성료6개월수방,TACI적예후최차,POCI화LACI예후상대교호,PACI차지.결론:뇌경사이LACI거다,OCSP분형가유효예측뇌경사환자원기예후공능.유필요진일보확대양본진행다중심전첨성연구.
BACKGROUND: Oxfordshire Community Stroke Project(OCSP) is a new type of clinical classification for subdividing cerebral infarction(CI) conducted on the basis of a large-scale of investigation of stroke in the population of Oxfordshire Community, England in 1991. This kind of classification completely bases on the clinical manifestations without the help of diagnostic instruments, which can predict site and size of the lesion and the involved vessels.OBJECTIVE: To acknowledge the clinical classification of CI patients with Bamford's OCSP and its significance in predicting their long-term functional prognosis.DESIGN: Clinical observation, comparison and verified study based on patients.SETTING: Neurological department in a university hospital.PARTICIPANTS: Between January 1st and December 31st 2001, totally 126 patients with cerebrovascular disease were hospitalized in the Neurological Department of First Affiliated Hospital of Xi' an Jiaotong University,including 82 males and 44 females.METHODS: Totally 126 in-patients with CI were subdivided with Bamford's OCSP classification, and their disablity was assessed with Barthel index (BI)and modified Rankin Scale(mRS) when they were discharged and 3 months and 6 months later.MAIN OUTCOME MEASURES: Classification of patients with CI and their scores of BI and mRS when they were discharged and 3 months and 6months later.RESULTS: Of the 126 patients, 8(6. 3% ) patients were confirmed of total anterior circulation infarction (TACI), 29 (23. 0% ) of part anterior circulation infarction(PACI), 78(61.9% ) of lacunar infarction(LACI), 11(8.7%) of posterior circulation infarction(POCI) . They were followed-up for 6 months, and meanwhile 12 patients died. Of the other 114 cases the prognosis of TACI was the worst, while the prognosis of POCI and LACI was relatively better than that of PACI.CONCLUSION: CI is predominated by LACI. OCSP is effective for predicting long-term functional prognosis of patients with CI. But it is necessary to make multi-center prospective study on a much larger scale of samples of disease.