急性缺血性脑卒中后局部血流灌注与失语类型及预后的相关性分析  

Analysis of the relationship between regional blood perfusion and type of aphasia and its prognosis after acute ischemic stroke

作　　者：李聪颖 杨伟民[1] 黄文祥 LI Congying;YANG Weimin;HUANG Wenxiang(Department of Neurology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院神经内二科,河南郑州450052

出　　处：《中国实用神经疾病杂志》2018年第20期2238-2243,共6页Chinese Journal of Practical Nervous Diseases

基　　金：2016年度河南省医学科技攻关计划(编号:162102310201)

摘　　要：目的探讨急性缺血性脑卒中后失语类型与局部血流灌注的相关性并分折影响预后的相关危险因素。方法收集2016-01-2017-10在郑州大学第一附属医院神经内科住院的急性脑卒中患者,根据失语量表对其进行失语评分及分类。对纳入的患者进行颅脑血管成像(CTA)及CT灌注成像(CTP)检查,记录病灶局部及镜像侧血流灌注参数,观察不同类型失语与脑局部血流灌注的相关性并分析影响其预后的相关因素。结果 127例失语患者中69例存在病灶区灌注不足,不同的语言功能障碍与相应区域的脑血流低灌注有关(P<0.05),失语严重程度与受累病灶区低灌注的程度关系密切(P<0.05)。结论以ABC量表所得评分及波士顿诊断性失语严重程度分级标准作为卒中后失语患者评价失语严重程度标准,进行语言功能与局部脑灌注的相关性分析,语言功能障碍程度与不同区域的脑血流灌注减低量呈正相关,即局部灌注越差,语言功能障碍程度越高。年龄>60岁、入院NIHSS评分较高及病灶局部脑血流减少是其预后不良的危险因素。Objective To explore the relationship between type of aphasia and regional blood perfusion after acute ischemic stroke and analyze related risk factors affecting prognosis.Methods To collect acute stroke patients admitted to the Department of Neurology,First Affiliated Hospital of Zhengzhou University from January 2016 to October 2017,grade and classify aphasia according to the aphasia scale.Cerebral vascular imaging(CTA)and CT perfusion imaging(CTP)were performed on the included patients,and record their local and mirror image of perfusion parameters,Observe the correlation between different types of aphasia and cerebral blood flow perfusion and analyze the related factors that affect its prognosis.Results In 127 patients with aphasia,69 patients had insufficient perfusion in the lesion area.Different language dysfunctions are related to cerebral blood flow hypoperfusion in the corresponding regions(P<0.05).The severity of aphasia is closely related to the degree of hypoperfusion in the affected lesion area(P<0.05).Conclusion The scores on the ABC scale and the diagnostic criteria for the severity of diagnostic aphasia in Boston were used as the criteria for assessing the severity of aphasia in patients with aphasia after stroke.The correlation between language function and regional cerebral perfusion was analyzed.The degree of language dysfunction is positively correlated with the decrease of cerebral blood flow perfusion in different regions,that is,the worse the local perfusion,the higher the degree of language dysfunction.Ages>60 years.Higher NIHSS scores and decreased cerebral blood flow in lesions were risk factors for poor prognosis.

关 键 词：急性缺血性脑卒中 局部脑血流灌注 颅脑血管成像 CT灌注成像 失语类型 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]