急性腔隙性脑梗死的预后与梗死区供血动脉的关系  

Relationship between the prognosis of in - hospital patients with acute lacunar infarction and the supply artery of the infarction areas

作　　者：游平弟[1] 李康增[1] 郑建明[1] 郑志雄[1] 岳增昌[1] 王建忠[1] 叶晓峰[1] 

机构地区：[1]福建医科大学附属闽东医院神经内科,福建福安355000

出　　处：《中国急救医学》2012年第5期394-397,共4页Chinese Journal of Critical Care Medicine

摘　　要：目的 探讨不同梗死区供血动脉对急性腔隙性脑梗死预后的影响.方法 收集经MRI检查证实的急性腔隙性脑梗死住院病例,根据其梗死部位的供血动脉对病例进行分组,通过电话沟通的方式对患者进行随访,用Rankin（MRS）评分和Barthel指数（BI）对患者的康复情况进行评估以及分析影响其预后的危险因素.根据MRS评分和BI指数将病例分为预后好组和预后差组,用Logistic回归分析筛查对预后产生影响的因素.结果 共随访到102病例,分为大脑中动脉深穿支27例,脉络膜前动脉44例,基底动脉旁中央支20例,大脑后动脉深穿支11例,共4组.各组预后比较差异无统计学意义（P〉0.05）.高龄、糖尿病史或高胆固醇血症史的患者较其他患者的预后差（P〈0.05）.结论 急性腔隙性脑梗死的预后与供血动脉无显著相关性.高龄、糖尿病史和高胆固醇血症史的患者预后较差.Objective To investigate the effect of different supply artery of the infarction areas on the prognosis of the in - hospital patients with acute lacunar infarction. Methods The acute lacunar infarction cases confirmed by the MRI were enrolled. All of the cases were divided into different groups according to the supply artery of the infarction areas and followed up by telephone. The outcomes of patients were evaluated by the Rankin Score （MRS） and the Barthel Index （BI）, and were compared among different groups as well as the risk factors. All of the eases were also divided into the good and poor outcome groups according to the MRS. The factors affecting the outcome of patients were screened by the Logistic regression analysis. Results 102 cases were enrolled and divided into four groups： deep perforating branches of middle cerebral artery （ n = 27 ） ; anterior choroidal artery （ n = 44 ） ; the central branches of basilar artery （n = 20） ; deep perforating branches of the posterior cerebral artery （ n = 11 ）. The MRS and BI showed no difference among the different groups （ P 〉 0.05 ）. The cases who were elderly, had diabetes history or hypercholesterolemia showed the worse outcome than the others （P 〈 0.05）. Conclusion There was no significant relationship between the prognosis of the acute lacunar infarction cases and supply artery. Patients who were elderly, had history of diabetes or hypercholesterolemia may have worse prognosis.

关 键 词：腔隙性脑梗死 供血动脉 预后 

分 类 号：R743.33[医药卫生—神经病学与精神病学]