国际脑血管病杂志
國際腦血管病雜誌
국제뇌혈관병잡지
INTERNATIONAL JOURNAL OF CEREBROVASCULAR DISEASES
2015年
1期
1-5
,共5页
卒中%脑缺血%疾病恶化%颅内动脉硬化%脑血管造影术%大脑中动脉%颈动脉狭窄%危险因素%时间因素
卒中%腦缺血%疾病噁化%顱內動脈硬化%腦血管造影術%大腦中動脈%頸動脈狹窄%危險因素%時間因素
졸중%뇌결혈%질병악화%로내동맥경화%뇌혈관조영술%대뇌중동맥%경동맥협착%위험인소%시간인소
Stroke%Brain Ischemia%Disease Progression%Intracranial Arteriosclerosis%Cerebral Angiography%Middle Cerebral Artery%Carotid Stenosis%Risk Factors%Time Factors
目的 探讨大动脉狭窄与大脑中动脉供血区梗死患者早期神经功能恶化(early neurological deterioration,END)的相关性.方法 回顾性收集大脑中动脉供血区脑梗死患者,END定义为入院72 h内美国国立卫生研究院卒中量表(National Institutes of ealth Stroke Scale,NIHSS)评分较基线值增加≥2分.利用颅脑血管成像对大脑中动脉和颈内动脉进行评价,狭窄程度分为无或轻度(＜50％)、中度(50％ ～ 70％)、重度(71％ ～99％)和闭塞(100％).比较END组与非END组的临床危险因素、神经功能缺损程度、病灶大小以及主干动脉病变情况.结果 共纳入256例大脑中动脉供血区梗死患者,其中70例(27.34％)患者发生END.END阳性组年龄(P=0.045)、梗死体积(P=0.045)、基线NIHSS评分(P=0.007)以及主干动脉狭窄程度(P=0.038)均显著高于或大于END阴性组.多变量logistic回归分析显示,基线NIHSS评分较高[优势比(odds ratio,OR)1.071,95％可信区间(confidence interval,CI)1.004～1.142;P=0.037]、梗死灶直径＞20 mm(OR 2.077,95％ CI1.077～3.736;P=0.028)以及主干动脉重度狭窄(OR 2.521,95％ CI1.079 ～5.886;P =0.033)或闭塞(OR3.074,95％ CI1.262 ～7.489;P =0.013)是END的独立预测因素.结论 主干动脉重度狭窄或闭塞病变可能是急性大脑中动脉供血区梗死患者发生END的独立预测因素.
目的 探討大動脈狹窄與大腦中動脈供血區梗死患者早期神經功能噁化(early neurological deterioration,END)的相關性.方法 迴顧性收集大腦中動脈供血區腦梗死患者,END定義為入院72 h內美國國立衛生研究院卒中量錶(National Institutes of ealth Stroke Scale,NIHSS)評分較基線值增加≥2分.利用顱腦血管成像對大腦中動脈和頸內動脈進行評價,狹窄程度分為無或輕度(＜50％)、中度(50％ ～ 70％)、重度(71％ ～99％)和閉塞(100％).比較END組與非END組的臨床危險因素、神經功能缺損程度、病竈大小以及主榦動脈病變情況.結果 共納入256例大腦中動脈供血區梗死患者,其中70例(27.34％)患者髮生END.END暘性組年齡(P=0.045)、梗死體積(P=0.045)、基線NIHSS評分(P=0.007)以及主榦動脈狹窄程度(P=0.038)均顯著高于或大于END陰性組.多變量logistic迴歸分析顯示,基線NIHSS評分較高[優勢比(odds ratio,OR)1.071,95％可信區間(confidence interval,CI)1.004～1.142;P=0.037]、梗死竈直徑＞20 mm(OR 2.077,95％ CI1.077～3.736;P=0.028)以及主榦動脈重度狹窄(OR 2.521,95％ CI1.079 ～5.886;P =0.033)或閉塞(OR3.074,95％ CI1.262 ～7.489;P =0.013)是END的獨立預測因素.結論 主榦動脈重度狹窄或閉塞病變可能是急性大腦中動脈供血區梗死患者髮生END的獨立預測因素.
목적 탐토대동맥협착여대뇌중동맥공혈구경사환자조기신경공능악화(early neurological deterioration,END)적상관성.방법 회고성수집대뇌중동맥공혈구뇌경사환자,END정의위입원72 h내미국국립위생연구원졸중량표(National Institutes of ealth Stroke Scale,NIHSS)평분교기선치증가≥2분.이용로뇌혈관성상대대뇌중동맥화경내동맥진행평개,협착정도분위무혹경도(＜50％)、중도(50％ ～ 70％)、중도(71％ ～99％)화폐새(100％).비교END조여비END조적림상위험인소、신경공능결손정도、병조대소이급주간동맥병변정황.결과 공납입256례대뇌중동맥공혈구경사환자,기중70례(27.34％)환자발생END.END양성조년령(P=0.045)、경사체적(P=0.045)、기선NIHSS평분(P=0.007)이급주간동맥협착정도(P=0.038)균현저고우혹대우END음성조.다변량logistic회귀분석현시,기선NIHSS평분교고[우세비(odds ratio,OR)1.071,95％가신구간(confidence interval,CI)1.004～1.142;P=0.037]、경사조직경＞20 mm(OR 2.077,95％ CI1.077～3.736;P=0.028)이급주간동맥중도협착(OR 2.521,95％ CI1.079 ～5.886;P =0.033)혹폐새(OR3.074,95％ CI1.262 ～7.489;P =0.013)시END적독립예측인소.결론 주간동맥중도협착혹폐새병변가능시급성대뇌중동맥공혈구경사환자발생END적독립예측인소.
Objective To investigate the correlation of large artery stenosis and early neurological deterioration (END) of middle cerebral artery infarction.Methods The patients with middle cerebral artery infarction were enrolled retrospectively.END was defined as that the National Institutes of Health Stroke Scale (NIHSS) scores increased ≥2 within 72 hours of admission compared with the baseline value.Middle cerebral artery and internal carotid artery were evaluated by using cerebral angiography.The degree of stenosis was divided into 4 grades:non-or mild (＜ 50％),moderate (50-70％),severe (71-99％) stenosis,and occlusion (100％).The clinical risk factors,degree of neurological deficits,size of lesion,and major arterial lesions were compared between the END group and the non-END group.Results A total of 256 patients with middle cerebral artery infarction were enrolled,and END occurred in 70 of them (27.34％).The age (P =0.045),infarct volume (P =0.045),baseline NIHSS score (P=0.007),and major arterial stenosis (P =0.038) of the END positive group were significantly higher or lager than those of the END negative group.Multivariate logistic regression analysis showed that the higher baseline NIHSS score (odds ratio [OR] 1.071,95％ confidence interval [CI] 1.004-1.142; P =0.037),infarction diameter ＞ 20 mm (OR 2.077,95％ CI 1.077-3.736; P =0.028),and severe stenosis of the major artery (OR 2.521,95％ CI 1.079-5.886; P=0.033) or occlusion (OR 3.074,95％ CI1.262-7.489; P=0.013) were the independent predictor of END.Conclusions Severe stenosis or occlusion of the major artery may be an independent predictor of END in patients with middle cerebral artery infarction.
