大脑后动脉偏侧优势对大脑中动脉M1段闭塞的预后分析  

Prognostic effect of posterior cerebral artery laterality on middle cerebral artery occlusion

作　　者：陈响亮[1] 熊云云[1] 李永坤[2] 马敏敏[1] 刘新峰[1] 

机构地区：[1]南京大学医学院附属金陵医院(南京军区南京总医院神经内科),210002 [2]福建省立医院神经内科

出　　处：《中华医学杂志》2013年第43期3428-3432,共5页National Medical Journal of China

基　　金：国家自然科学基金 （81220108008,31171016）;江苏省自然科学基金 （BK2011021）

摘　　要：目的 探讨磁共振血管造影（MRA）所见的大脑后动脉（PCA）偏侧优势对行药物治疗的大脑中动脉（MCA）M1段闭塞患者预后的影响.方法 回顾性选取2009年6月至2013年3月南京卒中登记系统中40例以MCA M1段闭塞为责任血管区并行药物治疗的脑梗死患者,根据MRA分为PCA偏侧优势阴性组和阳性组,比较两组的预后差异（以3个月mRS=0～1为预后良好）.采用t检验、Mann-Whitney U检验、χ2检验、Logistic回归分析等方法进行统计分析.结果 40例患者中20例表现为PCA偏侧优势阳性,共有32例患者完成3个月mRS评分.PCA偏侧优势未对预后产生显著影响（P=0.433）,而入院NIHSS评分对预后影响显著[预后良好比预后不好为（3.4±2.8）分比（8.1±3.7）分,P=0.002],是预后的独立预测因子（P=0.016）.结论 PCA偏侧优势对行药物治疗的MCA M1段闭塞患者的预后未见显著影响.Objective To explore the prognostic value of posterior cerebral artery （PCA） laterality in patients with symptomatic middle cerebral artery （MCA） occlusion on standard medical therapy. Methods Forty consecutive patients with first onset isolated atherosclerotic occlusion in M1 segment of MCA received medication from June 2009 to March 2013. All patients underwent magnetic resonance angiography （MRA） for assessment of PCA laterality. Clinical data and modified Rankin Scale （mRS） at 3 months were compared between PCA positive and negative patients. Retrospective analysis was performed on their clinical and imaging data. Results Among them, 20 patients （50%） showed PCA laterality on MRA and 32 patients （80%） completed a 3-month follow-up. No significant difference existed between PCA laterality positive and negative groups in a favorable outcome of mRS = 0-1 at 3 months （ P = 0. 433 ）. Conclusion The presence of PCA laterality showed no prognostic effect on patients with symptomatic MCA occlusion on standard medical therapy.

关 键 词：脑梗死 大脑中动脉 磁共振血管造影术 大脑后动脉 预后 

分 类 号：R743[医药卫生—神经病学与精神病学]