症状性颈动脉狭窄对急性脑梗死患者短期预后的影响  

Effect of symptomatic carotid artery stenosis on short-term outcome in acute ischemic stroke patients

作　　者：方传勤[1] 吴小三[1] 

机构地区：[1]安徽医科大学第二附属医院神经内科,合肥230601

出　　处：《中华老年心脑血管病杂志》2014年第3期233-236,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：安徽医科大学第二附属医院博士科研启动基金项目(2012BKJ0177)

摘　　要：目的 评估症状性颈动脉狭窄对急性缺血性脑梗死短期预后的影响.方法 选取前循环急性缺血性脑梗死患者421例,通过血管影像学检查评估颈动脉,根据颈动脉狭窄程度分为颈动脉重度狭窄组44例,中度狭窄组43例和轻度或无狭窄组334例.采用多元logistic回归分析评估颈动脉狭窄程度与急性脑梗死短期预后的关系.结果 与中度狭窄组和轻度或无狭窄组比较,重度狭窄组病死率、神经功能恶化和不良转归比例更大,住院时间更长（P＜0.05,P＜0.01）.多元logistic分析显示,与中度狭窄组比较,重度狭窄组患者死亡风险更高（OR=2.564,95％CI：0.469～14.009）,神经功能恶化（OR=2.037,95％CI：0.742～5.922）、不良转归更严重（OR=2.347,95％CI：0.988～5.577）和住院时间延长（OR=7.000,95％CI：2.662～18.409）.结论 症状性颈动脉重度狭窄是急性脑梗死短期不良预后的独立预测因素,因此,针对症状性颈动脉重度狭窄的患者应尽早采取积极的干预措施.Objective To assess the effect of symptomatic carotid artery stenosis on short-term outcome in acute ischemic stroke （AIS） patients.Methods Four hundred and twenty-one AIS patients were divided into severe carotid artery stenosis group（n=44）,moderate carotid artery stenosis group （n=43）,and mild or non-carotid artery stenosis group （n=334）.Relation between severity of carotid artery stenosis and short-term outcome of AIS was assessed by logistic regression analysis.Results The risk of death,neurological function deterioration and poor prognosis was greater,and the hospital stay time was longer in severe carotid artery stenosis group than in moderate and mild carotid artery stenosis groups.The mortality was higher,the neurological function deterioration was severer,the prognosis was poorer,and the hospital stay time was longer in severe carotid artery stenosis group than in moderate carotid artery stenosis group （OR=2.564,95%CI：0.469-14.009;OR=2.037,95%CI：0.742-5.922;OR=2.347,95%CI：0.988-5.577;OR=7.000,95%CI：2.662-18.409）.Conclusion Symptomatic severe carotid artery stenosis is an independent predictor for the poor short-term outcome in AIS patients.Active intervention measures should thus be taken as early as possible for it.

关 键 词：颈动脉狭窄 脑梗死 诊断显像 支架 早期诊断 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]