中华神经科杂志
中華神經科雜誌
중화신경과잡지
Chinese Journal of Neurology
2010年
8期
534-537
,共4页
脑梗死%功能恢复%磁共振成像,弥散%预测
腦梗死%功能恢複%磁共振成像,瀰散%預測
뇌경사%공능회복%자공진성상,미산%예측
Cerebral infarction%Recovery of function%Diffusion magnetic resonance imaging%Forecasting
目的 对急性期内的运动功能残疾的皮质下脑梗死患者进行观察,探讨弥散张量纤维素成像(DTT)显示的锥体束累及程度等多个预测因素对运动功能改变的影响,以期发现最可靠和最密切的预测因素.方法 对82例急性脑梗死残疾患者(mRS评分≥3分),结合其基线临床特征、实验室与影像学等辅助检查及治疗方法 ,选取性别、年龄、高血压、糖尿病、高胆固醇血症、心房颤动或心绞痛史、吸烟史、酗酒史、初始残疾程度、同型半胱氨酸、C反应蛋白、治疗方式、梗死灶体积大小及锥体束累及程度作为观测指标,对患者发病后第90天的情况进行随访分析.结果 单因素差异检验采用x2检验,发现年龄(χ2=47.492,P＜0.01)、糖尿病(χ2=5.126,P=0.024)、高胆固醇血症(χ2=6.242,P=0.012)、初始残疾程度(χ2=45.359,P＜0.01)、锥体束累及程度(χ2=51.467,P＜0.01)均可影响残疾患者的康复.采用多因素Logistic回归分析对其进行多因素回归分析,结果提示年龄(OR=0.068,P=0.042)、锥体束累及程度(OR=0.026,P=0.002)是患者运动功能康复的独立预测因素,而糖尿病、高胆固醇血症、初始残疾程度无明显相关性.结论 通过DTT反映出的锥体束累及程度为对在急性期内的运动功能残疾的皮质下脑梗死患者的康复最有价值的预测因素.
目的 對急性期內的運動功能殘疾的皮質下腦梗死患者進行觀察,探討瀰散張量纖維素成像(DTT)顯示的錐體束纍及程度等多箇預測因素對運動功能改變的影響,以期髮現最可靠和最密切的預測因素.方法 對82例急性腦梗死殘疾患者(mRS評分≥3分),結閤其基線臨床特徵、實驗室與影像學等輔助檢查及治療方法 ,選取性彆、年齡、高血壓、糖尿病、高膽固醇血癥、心房顫動或心絞痛史、吸煙史、酗酒史、初始殘疾程度、同型半胱氨痠、C反應蛋白、治療方式、梗死竈體積大小及錐體束纍及程度作為觀測指標,對患者髮病後第90天的情況進行隨訪分析.結果 單因素差異檢驗採用x2檢驗,髮現年齡(χ2=47.492,P＜0.01)、糖尿病(χ2=5.126,P=0.024)、高膽固醇血癥(χ2=6.242,P=0.012)、初始殘疾程度(χ2=45.359,P＜0.01)、錐體束纍及程度(χ2=51.467,P＜0.01)均可影響殘疾患者的康複.採用多因素Logistic迴歸分析對其進行多因素迴歸分析,結果提示年齡(OR=0.068,P=0.042)、錐體束纍及程度(OR=0.026,P=0.002)是患者運動功能康複的獨立預測因素,而糖尿病、高膽固醇血癥、初始殘疾程度無明顯相關性.結論 通過DTT反映齣的錐體束纍及程度為對在急性期內的運動功能殘疾的皮質下腦梗死患者的康複最有價值的預測因素.
목적 대급성기내적운동공능잔질적피질하뇌경사환자진행관찰,탐토미산장량섬유소성상(DTT)현시적추체속루급정도등다개예측인소대운동공능개변적영향,이기발현최가고화최밀절적예측인소.방법 대82례급성뇌경사잔질환자(mRS평분≥3분),결합기기선림상특정、실험실여영상학등보조검사급치료방법 ,선취성별、년령、고혈압、당뇨병、고담고순혈증、심방전동혹심교통사、흡연사、후주사、초시잔질정도、동형반광안산、C반응단백、치료방식、경사조체적대소급추체속루급정도작위관측지표,대환자발병후제90천적정황진행수방분석.결과 단인소차이검험채용x2검험,발현년령(χ2=47.492,P＜0.01)、당뇨병(χ2=5.126,P=0.024)、고담고순혈증(χ2=6.242,P=0.012)、초시잔질정도(χ2=45.359,P＜0.01)、추체속루급정도(χ2=51.467,P＜0.01)균가영향잔질환자적강복.채용다인소Logistic회귀분석대기진행다인소회귀분석,결과제시년령(OR=0.068,P=0.042)、추체속루급정도(OR=0.026,P=0.002)시환자운동공능강복적독립예측인소,이당뇨병、고담고순혈증、초시잔질정도무명현상관성.결론 통과DTT반영출적추체속루급정도위대재급성기내적운동공능잔질적피질하뇌경사환자적강복최유개치적예측인소.
Objective To observe the patients with subcortical cerebral infarction in the acute period, disabled in the motor function, and explore the extent of impact of several predictive factors to the recovery of motor function, including diffusion tensor imaging (DTF) displaying the involving extent of pyramidal tract, in order to find the most reliable and closely predictors. Methods 82 patients with acute cerebral infarction and disability (mRS score ≥ 3 points) were followed up on the 90 d after the symptom onset, respectively. Combining the baseline clinical characteristics, the laboratory and imaging auxiliary examination and treatment methods, choosing gender, age, hypertension, diabetes, hypercholesterolemia,atrial fibrillation or angina history, smoking history, alcohol history, the initial disability level,homocysteine, C-reactive protein, treatment modalities, the volume of infarction and the involving extent of pyramidal tract as observed indicators. According to mRS result, the outcome of the patients were divided into disabled groups ( mRS 3-5) and non-disabled group ( mRS 0-2). Results Using chi-square test to make univariate analysis, results showed that age (χ2 = 47.492, P ＜ 0. 01 ), diabetes ( χ2 = 5. 126, P =0. 024), hypercholesterolemia(χ2 =6. 242 ,P = 0. 012), the initial degree of disability (χ2 =45. 359, P ＜0. 01 ) and the involving extent of pyramidal tract (χ2 = 51. 467, P ＜ 0. 01 ) could effect patients gaining recovering. Using multivariate Logistic regression analysis to make a multivariate regression analysis, results suggest that age ( OR = 0. 068, P = 0. 042), the involving extent of pyramidal tract ( OR = 0. 026, P = 0. 002 )are independent predictors of recovery of motor function in patients, diabetes mellitus, hypercholesterolemia,initial disability level have no significant correlation. Conclusion The involving extent of pyramidal tract reflected by DTT is the best predictor of recovery in patients with subcortical cerebral infarction in the acute period.
