扩展版NIHSS对NIHSS评分0分延髓梗死的评估价值  

Evaluation value of extended NIHSS on medullary infarction with NIHSS score = 0

作　　者：季蕾[1] 蒋颖[1] 岳春贤 叶丹[1] 刘猛[1] 吴坚[1] 盛世英[1] 练学淦[1] JI Lei;JIANG Ying;YUE Chun-xian(Department of Neurology,the Third Affiliated Hospital of Soochow University,Changzhou 213003,China)

机构地区：[1]苏州大学附属第三医院神经内科,常州213003

出　　处：《临床神经病学杂志》2018年第6期418-421,共4页Journal of Clinical Neurology

基　　金：江苏省社会发展项目(BE2016659);常州市社会发展项目(CE20165026);常州市应用基础研究(CJ20179062)

摘　　要：目的探讨扩展版NIHSS(e-NIHSS)对NIHSS评分0分的延髓梗死患者神经功能障碍的评估价值。方法纳入经头颅MRI证实的NIHSS评分0分首发延髓梗死的患者,记录脑血管危险因素、症状、体征、影像学表现、e-NIHSS评分。结果共纳入9例延髓梗死患者,脑血管病危险因素中高血压7例(77. 78%),糖尿病4例(44. 44%),高脂血症6例(66. 67%),高同型半胱氨酸2例(22. 22%),吸烟5例(55. 56%),饮酒5例(55. 56%),冠心病1例(11. 11%),血小板增多症2例(22. 22%)。临床症状头晕6例(66. 67%)、呕吐3例(33. 33%)、行走不稳3例(33. 33%)、吞咽困难1例(11. 11%)、进食呛咳2例(22. 22%)、肢体麻木1例(11. 11%),体征咽反射减弱或提腭无力6例(66. 67%)、躯干性共济失调6例(66. 67%)、Horner征3例(33. 33%),影像学表现全部为延髓外侧梗死,位于延髓近端1例(11. 11%)、远端4例(44. 44%)、中间4例(44. 44%),e-NIHSS评分0～6分,平均(3. 55±1. 81)分。结论 e-NIHSS量表应用于延髓梗死是对NIHSS量表的有效补充。Objective To study the value of expanded-NIHSS (e-NIHSS)in evaluating the neurological signs of medullary infarction with Zero score on the NIHSS.Methods Patients with primary medullary infarction proved by Magnetic Resonance imaging were enrolled in this study,which were Zero score on the NIHSS. Risk factors of stroke, clinical presentation,neurological signs,imaging performance and e-NIHSS score were recorded. Results Nine patients were enrolled in this study. Risk factors of stroke were hypertension (7,77.78%),diabetes mellitus (4, 44.44%),hyperlipemia (6,66.67%),hyperhomocysteinemia (2,22.22%),smoking (5,55.56%),drinking (5,55.56%),coronary heart disease (1,11.11%) and thrombocythemia (2,22.22%). The clinical presentation were dizzy (6,66.67%),vomiting (3,33.33%),lateropulsion (3,33. 33%),dysphagia (1, 11.11%),choking (2,22.22%)and limb numbness (1,11.11%). The neurological signs were palate paralysis (6,66.67%),trunk ataxia (6,66.67%),Horner's syndrome (3,33.33%). All patients were lateral medullary infarction with proximal 1 (11.11%),middle 4 (44.44%)and distal 4 (44.44%). The e-NIHSS score was 0-6 (3.55 ± 1.81). Conclusions The e-NIHSS could be a supplement of NIHSS in evaluating the neurological signs of medullary infarction.

关 键 词：延髓梗死 体征 扩展 NIHSS 

分 类 号：R743.3[医药卫生—神经病学与精神病学]