广州社区前循环伴构音障碍脑梗死患者临床预后分析  

Clinical prognosis of patients with cerebral infarction in anterior circulation and dysarthria in Guangzhou communities

作　　者：马己才 刘秦[1] 林杰[1] 吴卓华[1] 沈粤春[2] 李少明[1] 徐评议[1] 田作军[1] MA Ji -cai;LIU Qin;LIN Jie;WU Zhuo -hua;SHEN Yue -chun;LI Shao -ming;XU Ping -yi;TIAN Zuo -jun(Department of Neurology,First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510120,Guangdong,China)

机构地区：[1]广州医科大学附属第一医院神经内科,广东广州510120 [2]广州医科大学附属第一医院心内科,广东广州510120

出　　处：《广东医学》2018年第22期3330-3334,共5页Guangdong Medical Journal

基　　金：广东省科技计划项目(编号:2013B021800282;2014A020212350;2014A020212364);广州市科技计划项目(编号:201510010181)

摘　　要：目的探讨广州社区本地前循环伴构音障碍脑梗死患者的临床预后。方法收集住院治疗的广州本地新发前循环脑梗死患者292例,分为构音障碍组(65例)及言语正常组(227例),均接受相同处理。分析其主要临床预后:治疗后10、90及180 d两组能生活自理患者(mRS≤1)的比率及其他预后:治疗后的NIHSS、mRS及构音障碍Frenchay评分。结果构音障碍组患者入院时mRS≤1的比率明显低于言语正常组(χ~2=22. 685,P=0. 000),但在治疗后10、90和180 d的比率均和言语正常组类似(P> 0. 05);但其NIHSS和mRS评分在治疗10及90 d仍高于言语正常组(P <0. 01),直至治疗后180 d才降至与言语正常组相似的水平(P> 0. 05)。另外,构音障碍组患者入院时上肢的NIHSS评分高于下肢(Z=-5. 367,P=0. 000),治疗10d后上、下肢间差异无统计学意义(P> 0. 05);且在入院及治疗10 d时其Frenchay评分分别与当时的总体和上肢的NIHSS评分及mRS评分呈正相关(P <0. 05)。结论伴有构音障碍的前循环脑梗死患者在治疗前后症状通常比言语正常的患者更重;但由于下肢症状较轻,经过积极治疗,多数患者仍可取得与言语正常者相似的生活自理能力。Objective To investigate the clinical prognosis of local patients with cerebral infarction in anterior circulation and dysarthria in Guangzhou communities.Methods From November 2011to December 2014,292 inpatients with newly diagnosed cerebral infarction in anterior circulation were enrolled.The inpatients were divided into dysarthria group (65cases)and normal speech group (227 cases).Primary outcomes included functional independent patients (mRS ≤1)10,90and 180days after treatment;and other outcomes included NIHSS,mRS and Frenchay scores after treatment.Results The mRS ≤1 rate in dysarthria group was significantly lower than that in normal speech group at admission (x^2=22.685,P =0.000),though there was no significant difference in it between the 2 groups 10,90 or 180 days after treatment.The NIHSS and mRS remained significantly higher in dysarthria group than those in normal speech group 10 and 90 days after treatment (P <0.01),but there was no significant difference in those 180 days after treatment.In dysarthria group,the NIHSS of the upper limbs was significantly higher than that of lower limb at admission (Z=-5.367,P =0.000),but no statistical significance was found between the upper and lower limbs 10 days after treatment.The Frenchay score of the dysarthria patients was positively correlated with the patient's overall and upper limb NIHSS as well as the mRS score at admission and 10 days after treatment (P <0.05).Conclusion The patients with cerebral infarction in anterior circulation and dyspraxia usually have worse symptoms than those of normal -speech patients before and after treatment.However,most of them can still achieve a similar clinical functional independence as the patients with normal speech after positive treatment due to their relatively lighter lower limb symptoms.

关 键 词：前循环 脑梗死 构音障碍 社区研究 

分 类 号：R743.3[医药卫生—神经病学与精神病学]