Alberta卒中项目早期CT评分预测大脑中动脉脑梗死患者功能结局的研究  

The value of Alberta stroke program early CT score in functional outcome prediction in patients with middle cerebral artery infarction

作　　者：李秀明[1] 何嫱[1] 张备[1] 白玉龙[1,2] 吴毅[1,2] 胡永善[1,2] 

机构地区：[1]复旦大学附属华山医院康复医学科、复旦大学上海医学院康复与运动医学系,上海200040 [2]复旦大学附属华山医院永和分院康复医学科

出　　处：《中国康复医学杂志》2013年第9期811-816,共6页Chinese Journal of Rehabilitation Medicine

基　　金：上海市卫生局课题(2009局级250);上海市闸北区卫生局课题(2008重点05)

摘　　要：目的:探讨Alberta卒中项目早期CT评分(ASPECTS)对大脑中动脉脑梗死患者功能结局的预测价值。方法:共收集2010年8月—2011年8月入住我院康复中心治疗的大脑中动脉脑梗死患者89例,分别在发病后的第3个月、第6个月、第12个月进行随访。结合患者临床特征,选择性别、年龄、高血压病、糖尿病、高胆固醇血症、代谢综合征、同型半胱氨酸、吸烟史、酗酒史、改良Barthel指数、修订的Rankin评分、DWI-ASPECTS评分作为观察指标,进行单因素和多因素分析。结果:单因素差异检验采用Log-Rankχ2检验,发现年龄(P<0.05)、高胆固醇血症(P<0.05)、DWI-ASPECTS评分(P<0.05)均可影响患者功能的恢复。运用Cox回归模型对其进行多因素相关分析,提示年龄(P<0.01)和DWIASPECTS评分(P<0.01)是患者功能恢复的独立预测因素。结论:利用ASPECTS评分系统分析大脑中动脉脑梗死患者(排除DWI-ASPECTS<4分及腔隙性梗死)扩散加权成像(DWI)的早期缺血改变,可作为此类患者功能结局的预测指标。Objective： To assess whether Alberta stroke program early CT score （ASPECTS） on diffusion weighted imaging （DWI） is useful for predicting function outcome in patients with middle cerebral artery infarction. Method： A study was conducted, including 89 patients with diagnosis of middle cerebral artery infarction ad- mitted for rehabilitation in rehabilitation medicine department, from August 2010 to August 2011. Twelve vari- ables were collected with regard to the patients＇ medical history, including gender, age, history of hypertention, diabetes, hypercholesterolemia, smoking, metabolic syndrome, homocysteine, smoking history, alcohol history, modified Barthel index（MBl） and modified Rankin scale（MRS）. Then linear regression analysis was used to as- sess the potential variables. Result： Age （Z2 = 10.924, P 〈 0.05）, hypercholesterolemia （Z2 = 14.326, P 〈 0.05）, DWI-ASPECTS （X2 = 60.000, P 〈 0.05） each influenced the motor function recovery of patients. Using Cox modeling to perform multivariate regression analysis, it was found that age （B=3.719, P〈0.01）, DWI-ASPECTS （B=-3.220, P〈0.01） were inde- pendent predictors of of motor function recovery.Conclusion： When ASPECTS was performed to analyse early ischemic changes on DWI of patients with mid- dle cerebral artery infarction （except for DWI-ASPECTS 〈 4 and lacunar infarct）, the results were predicable in- dicators for function outcome of patients. Author＇s address Dept. of Rehabilitation Medicine, Huashan Hospital,Fudan University, Shanghai,200040

关 键 词：Alberta卒中项目早期CT评分 大脑中动脉脑梗死 功能结局 预测因素 

分 类 号：R743.33[医药卫生—神经病学与精神病学]