脑血管储备与腔隙性脑梗死早期神经功能恶化的相关性研究  

Relationship between Early Neurological Deterioration and Cerebrovascular Reserve in the Patients with Lacunar Infarction

作　　者：李贯绯[1] 李丽[1] 牛晓立[1] 杨宗辉[2] Li GuanfeiI Li LiI Niu XiaoliI Yang Zonghui(Department of Neurology, Jilin Provincial People＇ s Hospital, Changehun 130021 Chinese - Japan Union Hospital, Jilin University, Changehun 130021, China)

机构地区：[1] 吉林省人民医院神经内科,中国长春130021 [2]吉林大学中日联谊医院,中国长春130021

出　　处：《国际老年医学杂志》2016年第6期241-244,257,共5页International Journal of Geriatrics

基　　金：吉林省卫生计生委员会资助项目（2015S2C07）

摘　　要：目的：探讨急性腔隙性脑梗死（LI）患者出现早期神经功能恶化（END）与脑血管储备（CVR）改变的联系.方法：连续纳入发病24h内收治于吉林省人民医院神经内科的LI患者,根据发病72h内是否出现神经功能恶化,分为END组及非END组.采用经颅多普勒（TCD）结合CO2试验评价CVR功能,比较各组基线资料和CVR功能,筛选早期预测END的独立危险因素.结果：102例患者中有23例（22.5％）发生END,和非END患者比较,各项CVR参数及基线NIHSS评分的差异有统计学意义（P＜0.01）.Logistic回归分析显示,屏气指数（OR=0.258,95％ CI 0.045 ～1.482,P=0.002）、过度换气指数（OR=0.000,95％ CI 0.000 ～0.001,P=0.000）和基线NIHSS评分（OR=1.182,95％ CI 1.065～1.311,P=0.001）是END的独立危险因素.结论：CVR受损可能与LI早期病情不稳定有关,早期进行CVR检测有助于预测LI病情恶化.OBJECTIVE： To explore the relationship between early neurological deterioration （END） and cerebrovascular reserve （CVR） in the patients with lacunar infarction （LI）. METHODS： Consecutive patients with LI were admitted to Jilin Provincial Peo- ple＇ s Hospital. They were divided into END group and non -END group according to neurological deterioration. CVR was detected by transcranial Doppler uhrasonography （TCD） combined with CO2 test. The patients ＇ CVR and their background characteristics were compared. Risk factors associated with END were analyzed. RESULTS： A total of 102 patients were finally enrolled. 23 cases （22. 5% ） suffered END. Compared to the patients without END, there were statistically significant differences in the CVR parame- ters and baseline NIHSS score （ P 〈 0. 01 ）. Logistic regression analysis showed that BHI （ OR = 0. 258, 95% CI 0. 045 ~ 1. 482, P =0. 002）, HVI （OR =0. 000, 95% CI 0. 000 -0. 001, P =0. 000） and baseline NIHSS score （ OR = 1. 182, 95% CI 106. 5 - 1. 311, P =0. 001 ） were independent risk factors of END. CONCLUSION： CVR impairment may be associated with early unstablecondition in the patients with LI. Early detection of CVR is helpful to predict the severity of LI.

关 键 词：腔隙性脑梗死 脑血管储备 早期神经功能恶化 经颅多普勒 

分 类 号：R743.33[医药卫生—神经病学与精神病学]