CAJ | 학술논문

目的探讨颈动脉狭窄程度与缺血性进展性脑卒中(SIP)的关系.方法回顾性分析2009年1月至2011年12月本院收治的119例SIP患者的临床基本资料,在患者入院时及入院72 h后采用改良欧洲Skandinavien卒中量表(MESSS)评价患者的神经功能,应用颈动脉超声、螺旋CT 动脉血管造影(CTA)评价颈动脉血管狭窄程度,分析颈动脉不同狭窄程度患者的缺血性卒中进展情况.结果119例患者中颈动脉轻度狭窄89例(74.8%),中度12例(10.1%),重度狭窄10例(8.4%),完全闭塞8例(6.7%).随着狭窄程度的加重,MESSS下降率不断增加〔轻度(18.0±1.3)%、中度(26.0±2.2)%、重度(35.0±1.9)%〕,完全闭塞组明显减少〔(11.0±0.7)%〕,各组间比较差异有统计学意义(P<0.01).非闭塞组与闭塞组脑缺血发生率(52.3%比37.5%)比较差异无统计学意义(P=0.193).结论颈动脉狭窄程度可以作为预测SIP的指标;通过颈动脉超声、CTA可能为脑梗死的急性期进展提供有意义的资料.
목적탐토경동맥협착정도여결혈성진전성뇌졸중(SIP)적관계.방법회고성분석2009년1월지2011년12월본원수치적119례SIP환자적림상기본자료,재환자입원시급입원72 h후채용개량구주Skandinavien졸중량표(MESSS)평개환자적신경공능,응용경동맥초성、라선CT 동맥혈관조영(CTA)평개경동맥혈관협착정도,분석경동맥불동협착정도환자적결혈성졸중진전정황.결과119례환자중경동맥경도협착89례(74.8%),중도12례(10.1%),중도협착10례(8.4%),완전폐새8례(6.7%).수착협착정도적가중,MESSS하강솔불단증가〔경도(18.0±1.3)%、중도(26.0±2.2)%、중도(35.0±1.9)%〕,완전폐새조명현감소〔(11.0±0.7)%〕,각조간비교차이유통계학의의(P<0.01).비폐새조여폐새조뇌결혈발생솔(52.3%비37.5%)비교차이무통계학의의(P=0.193).결론경동맥협착정도가이작위예측SIP적지표;통과경동맥초성、CTA가능위뇌경사적급성기진전제공유의의적자료.
Objective To investigate the relationship between the degree of carotid stenosis and ischemic stroke in progression(SIP). Methods A retrospective analysis was conducted in 119 patients with SIP admitted at Taizhou Central Hospital from January 2009 to December 2011. We analyzed their basic clinical data,and evaluated their neurological functions on admission and 72-hour after admission by the Modified European Skandinavien Stroke Scale(MESSS)scoring criteria,using carotid ultrasound and spiral CT arterial angiography(CTA)to assess their degrees of carotid stenosis,to search for the progression of ischemic stroke in patients with different levels of carotid artery stenosis. Results Based on their levels of carotid artery stenosis,119 patients were divided into four groups:mild group(89 cases,74.8%),medium group(12 cases,10.1%),severe group(10 cases,8.4%)and occlusion group(8 cases,6.7%). Along with the increase of severity of stenosis,the MESSS descending rates showed a trend of consecutive increase:mild group(18.0±1.3)%;medium group(26.0±2.2)%;severe group(35.0±1.9)%;and remarkably declined occlusion group(11.0±0.7)%. Significant differences were noted among the four groups (P<0.01). There were no significant differences in the incidences of cerebral ischemia between non-occlusion group and occlusion group(52.3%vs. 37.5%,P=0.193). Conclusions The degree of carotid stenosis can be used as an indicator to predict the SIP. The examinations of carotid artery ultrasound and CTA can provide useful information for the progression in acute phase of cerebral infarction.