急性脑梗死患者病因分型特点及其预后研究  

Study on the features and prognosis in the patients with different subtypes of acute cerebral infarction

作　　者：朱艳 刘刚[1] 杨德刚 徐耀 黄金忠 刘筱洁 陈应柱 袁成林 

机构地区：[1]扬州大学临床医学院神经内科,江苏225001

出　　处：《中国急救医学》2009年第12期1118-1120,共3页Chinese Journal of Critical Care Medicine

摘　　要：目的了解急性脑梗死（ACI）患者急性卒中治疗低分子肝素试验（TOAST）分型的构成特点及其与预后的相关性。方法对164例ACI患者进行美国国立卫生研究所卒中量表（NIHSS）评分，并按照TOAST标准分为5大亚型，分析不同亚型与NIHSS评分的关系。结果本组TOAST各亚型构成比：小动脉闭塞型42．68％、大动脉粥样硬化型17．07％、心源性栓塞型10．37％、其他病因型3．66％和不明原因型26．22％；TOAST五个亚型中，心源性栓塞型NIHSS评分最高，其次为大动脉粥样硬化型，而小动脉闭塞型最低；与小动脉闭塞型比较，心源性栓塞型、大动脉粥样硬化型NIHSS评分差异有统计学意义（P〈0．01）。结论ACI患者NIHSS评分水平随TOAST亚型的不同而变化。Objective To study the features of different subtypes in acute cerebral infarction （ACI） based on the criteria of The Trial of Org 10172 in Acute Stroke Treatment（TOAST） and the relationship with the prognosis in acute infarction patients. Methods 164 ACI patients were divided into 5 groups based on the criteria of TOAST. All the patients were scored according to the American National Institutes of Health Stroke Scale （ NIHSS ）. To explore the relationship between the score and different subtypes. Results The percentage of each ischemic stroke TOAST subtype was as follows： small - vessel occlusion 42. 68%, large - artery atherosclerosis 17.07%, cardioembolism 10. 37%, stroke of other determined etiology 3.66%, stroke of undetermined etiology 26. 22%. Among 5 major stroke subtypes, cardioembolism patients had the highest NIHSS score. Small - vessel occlusion subtypes were associated with the lowest NIHSS score. Compared with small - vessel occlusion subtypes, NIHSS score increased significantly in cardioembolism and large - artery atherosclerosis patients （ P 〈 0. 01 ）. Conclusion NIHSS score varied in different subtypes of ACI.

关 键 词：急性脑梗死(ACI) 急性卒中治疗低分子肝素试验(TOAST) 美国国立卫生 研究所卒中评分量表(NIHSS) 

分 类 号：R743.33[医药卫生—神经病学与精神病学]