CAJ | 학술논문

目的：探讨症状性颈动脉狭窄对急性缺血性脑卒中患者近期生存状况的影响。方法根据血管影像学结果，252例急性缺血性脑卒中患者分为3组，重度狭窄组32例，中度狭窄组38例以及轻度或无狭窄组182例，观察发病3个月内NIHSS评分及BI评分变化、有无卒中复发、癫痫样发作、死亡。结果与中度狭窄组比较，重度狭窄组患者神经功能恶化（OR＝2.058，95％CI0.771～6.011，P＝0.000）、生活受限更严重（OR＝2.405，95％CI1.011～5.618，P＝0.000），死亡风险升高（OR＝2.587，95％CI0.483～14.017，P＝0.000）；与轻度或无狭窄组比较，重度狭窄组神经功能进一步恶化（OR＝10.389，95％CI4.438～24.317，P＝0.000），生活受限更重（OR＝3.211，95％CI1.691～6.134，P＝0.000），死亡风险更高（OR＝4.182，95％CI1.363～12.805，P＝0.000）。结论症状性颈动脉狭窄是急性缺血性脑卒中患者近期生存状况不佳的独立危险因素，可导致神经功能恶化、生活严重受限、死亡风险升高，应采取早期干预措施。
목적：탐토증상성경동맥협착대급성결혈성뇌졸중환자근기생존상황적영향。방법근거혈관영상학결과，252례급성결혈성뇌졸중환자분위3조，중도협착조32례，중도협착조38례이급경도혹무협착조182례，관찰발병3개월내NIHSS평분급BI평분변화、유무졸중복발、전간양발작、사망。결과여중도협착조비교，중도협착조환자신경공능악화（OR＝2.058，95％CI0.771～6.011，P＝0.000）、생활수한경엄중（OR＝2.405，95％CI1.011～5.618，P＝0.000），사망풍험승고（OR＝2.587，95％CI0.483～14.017，P＝0.000）；여경도혹무협착조비교，중도협착조신경공능진일보악화（OR＝10.389，95％CI4.438～24.317，P＝0.000），생활수한경중（OR＝3.211，95％CI1.691～6.134，P＝0.000），사망풍험경고（OR＝4.182，95％CI1.363～12.805，P＝0.000）。결론증상성경동맥협착시급성결혈성뇌졸중환자근기생존상황불가적독립위험인소，가도치신경공능악화、생활엄중수한、사망풍험승고，응채취조기간예조시。
Objective To investigate the effect of symptomatic carotid artery stenosis on short-term living condition in pa-tients with acute ischemic stroke. Methods According to angiographic results ,252 patients with acute ischemic stroke were di-vided into severe carotid artery stenosis group (n=32) ,moderate carotid artery stenosis group (n=38) ,and mild or non-carot-id artery stenosis (n=182). NIHSS score and BI score change ,stroke recurrence or not ,epilepsy and death of all cases within 3 months were observed.Results Compared with moderate carotid artery stenosis group ,the neurological function deteriora-tion was severer(OR=2.058 ,95% CI 0.771-6.011 ,P=0.000) ,life was more severely limited(OR=2.405 ,95% CI 1.011-5.618 ,P=0.000) ,the morality was higher(OR=2.587 ,95% CI 0.483-14.017 ,P=0.000) in severe carotid artery stenosis group. Compared with mild or non-carotid artery stenosis ,the neurological function deterioration was further severer (OR=10.389 ,95% CI 4.438-24.317 ,P=0.000) ,life was more severely limited(OR=3.211 ,95% CI 1.691-6.134 ,P=0.000) , the morality increased further ( OR = 4.182 , 95% CI 1.363-12.805 , P = 0.000 ) in severe carotid artery stenosis group.Conclusion Symptomatic carotid artery stenosis is an independent risk factor for the poor short-term living condition in patients with acute ischemic stroke. It could cause severe neurological function deterioration ,more severely limited in life and higher morality. Early intervention measures should be taken.