急性颈内或大脑中动脉闭塞患者临床预后分析  

Prognosis of Patients with Acute Internal Carotid Artery or Middle Cerebral Artery Occlusion

作　　者：廖晓凌[1] 王伊龙[1] 王拥军[1] 薛静[1] 高培毅[1] 

机构地区：[1]首都医科大学附属北京天坛医院神经内科,北京市100050

出　　处：《中国康复理论与实践》2007年第8期714-715,共2页Chinese Journal of Rehabilitation Theory and Practice

基　　金："十五"国家科技攻关计划(No.2004BA714B06-2)

摘　　要：目的探讨急性颈内或大脑中动脉闭塞的缺血性卒中患者的临床预后及预测结局的因素。方法选择发病6h内磁共振血管造影检查示颈内或大脑中动脉闭塞的患者48例，收集临床及影像学数据，在90d后评定患者的改良Ranking量表（mRS）评分，Logistic回归分析临床结局相关因素。结果48例患者临床结局好者（mRS 0～2分）17例（35．4％），临床结局不良者（mRS 3～6分）31例（64．6％），其中7例（14．6％）死亡。Logistic回归分析仅大面积梗死（OR=21．1，95％CI1．4～314．2，P=0．027）及高血糖（OR=5．1，95％CI1．3～19．8，P=0．019）同临床结局不良相关。结论急性颈内或大脑中动脉闭塞患者大部分临床预后较差，大面积梗死及高血糖是预测临床结局的独立因素。Objective To investigate prognosis of acute ischemic patients with internal carotid artery or middle cerebral artery occlusion and define predictors of clinical outcome. Methods The clinical and radiological data of 48 stroke patients who underwent magnetic resonance angiography （MRA） within 6 hours of symptom onset and visualized internal carotid artery or middle cerebral artery occlusion on early MRA were analyzed. 90 days after onset, modified Ranking Scale （mRS） scores were obtained and factors related with prognosis were defined by logistic regression analysis. Results Of 48 patients, 17 cases （35.4%） got good clinical outcome （mRS 0～2）, 31 cases （64.6%） got poor clinical outcome （mRS 3～6） with 7 cases （14.6%） died. In multivariate logistic regression analysis, only large infarction （ OR =21.1, 95%CI 1.4～314.2, P =0. 027） and hyperglycaemia （ OR =5. 1, 95%CI 1.3～19.8, P =0. 019） were independent predictors of poor outcome. Conclusion Clinical outcomes of most acute stroke patients with internal carotid artery or middle cerebral artery occlusion are poor. Large infarction and hyperglycaemia are independent predictors of clinical outcome. 　

关 键 词：急性缺血性卒中 磁共振血管造影 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]