脑白质病变与小动脉闭塞性脑梗死早期神经功能恶化的关系  

Association between White Matter Lesions and Early Neurological Deterioration in Patients with Small Artery Occlusion Stroke

作　　者：李贯绯[1] 李丽[1] 牛晓立[1] 

机构地区：[1]吉林省人民医院,吉林长春130021

出　　处：《中国医学创新》2017年第15期1-4,共4页Medical Innovation of China

基　　金：吉林省卫生计生委员会资助项目(2015S2C07)

摘　　要：目的:探讨小动脉闭塞性脑梗死患者发生早期神经功能恶化(END)与脑白质病变(WMLs)的关系。方法:连续纳入2015年1月-2016年12月收治于本院神经内科发病48 h内的小动脉闭塞性脑梗死患者154例,按照发病72 h内是否出现神经功能恶化分为END组(n=36)和非END组(n=118)。比较两组的年龄、性别、既往病史、个人史、入院时基线美国国立卫生研究院卒中量表(NIHSS)评分、基线血压及相关实验室检查,同时应用头部MRI评估并比较两组的WMLs严重程度。结果:两组患者的年龄、性别、既往病史、个人史、基线血压、血脂、超敏C-反应蛋白和空腹血糖比较,差异均无统计学意义(P>0.05);END组基的线NIHSS评分高于非END组,差异有统计学意义(P=0.047)。END组的侧脑室周围及深部白质Fazekas量表评分均显著高于非END组,差异均有统计学意义(P<0.05)。结论:WMLs受损严重的患者发生病情恶化的风险更高,评估WMLs有助于临床预测急性小动脉闭塞性脑梗死患者的病情进展情况。Objective： To explore the association between white matter lesions （ WMLs ） and early neurological deterioration （ END ） in patients with small artery occlusion stroke.Method： Consecutive 154 patients with small artery occlusion stroke were admitted to our Hospital from January 2015 to December 2016, they were divided into END group （ n=36 ） and non-END group （ n=118 ） according to neurological deterioration within 72 hours of symptom onset. The WMLs, age, sex, previous history, personal history, baseline National Institute of Heahh Stroke Scale （ NIHSS ） scores, blood pressure and related laboratory examination of two groups were analyzed, the head MRI was used to assess and compare the WMLs severity of the two groups.Result： There were no statistically significant differences in age, sex, past medical history, personal history, baseline blood p^ressure, blood lipids, high sensitivity C-reactive protein, and fasting glucose between the two groups （ P〉0.05 ）; the NIHSS score of END group was higher than that in non-END group, the difference was statistically significant （ P=0.047 ） .The Fazekas scale SCORES at periventricular and deep white matter of the END group were significantly higher than those of the non-END group, the differences were statistically significant （ P〈0.05 ） .Conclusion： Patients with severely impaired WMLs are at a higher risk of worsening the condition, assessment of WMLs is useful in predicting the progression of acute arteriolar occlusion in patients with cerebral infarction.

关 键 词：脑白质病变 小动脉闭塞性脑梗死 早期神经功能恶化 

分 类 号：R743.3[医药卫生—神经病学与精神病学]