SWI皮质血管征对大脑中动脉脑梗死rt-PA静脉溶栓预后的评估  

Evaluation of the prognosis of rt-PA intravenous thrombolysis in patients with middle cerebral artery cerebral infarction by SWI cortical vessel sign

作　　者：李鹏辉 王冰[1] 秦灵芝[1] 王丽丽[1] LI Penghui;WANG Bing;QIN Lingzhi(Department of Neurology Henan Province People’s Hospital,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院神经内科

出　　处：《中风与神经疾病杂志》2019年第6期523-526,共4页Journal of Apoplexy and Nervous Diseases

摘　　要：目的探讨SWI皮质血管征和大脑中动脉脑梗死rt-PA静脉溶栓预后的关系。方法选取河南省人民医院258例急性大脑中动脉脑梗死静脉溶栓住院患者,采用3.0TMRI在溶栓前行DWI、SWI和PWI序列检查,溶栓24h后给予抗血小板聚集、辅助用药和持续康复训练,计算3m后改良的Rankin量表(Modified Rankin Scale,mRS)。根据mRS评分,分为预后良好组和预后不良组。首先SDM(SWI-DWI)和PDM(PWI-DWI)进行差异性比较;然后影响预后程度有关的因素进行Logistic回归分析,对有差异性因素进行回归参数的估计;最后,预后程度和溶栓前SDM/SWI比值进行两样本定量资料的比较,并行关联性分析。结果SDM和PDM比较(P>0.05),差异无统计学意义。年龄、治疗时间窗、卒中的严重程度和复发性卒中均和预后程度有关联,治疗时间窗(OR=8.381)复发性卒中(OR=6.194),卒中的严重程度(OR=3.234)和年龄(OR=2.682)。预后程度两组间溶栓前SDM/SWI比值差异有统计学意义(P<0.05);两变量行Spearman线性相关分析(r=0.683,P<0.05)。结论SWI皮质血管征可用于大脑中动脉脑梗死rt-PA静脉溶栓预后的评估,SDM/SWI比值和预后呈正相关。Objective To investigate the relationship between SWI cortical vessel sign and prognosis of rt-PA intravenous thrombolysis in middle cerebral artery infarction.Methods 258 inpatients with acute middle cerebral artery infarction and intravenous thrombolysis were selected from Henan Provincial People’s Hospital.DWI,SWI and PWI sequence check before thrombolysis using 3.0T MRI.Antiplatelet aggregation,adjuvant medication and continuous rehabilitation training were given 24 hours after thrombolysis.Calculate the improved Rankin scale after 3 months.According to the mRS score,it was divided into a good prognosis group and a poor prognosis group.First,SDM(SWI-DWI)and PDM(PWI-DWI)were compared.Then,the factors affecting the prognosis were analyzed by logistic regression analysis,and the regression parameters were estimated for the different factors.Finally,the degree of prognosis and the SDM/SWI ratio before thrombolysis were compared between two samples of quantitative data,and correlation analysis was conducted.Results The comparison of SDM and PDM was P>0.05 and the difference was not statistically significant.Age,treatment time window,severity of stroke,and recurrent stroke were all associated with prognosis.Treatment time window(OR=8.381),Recurrent stroke(OR=6.194),Severity of stroke(OR=3.234)and Age(OR=2.682).There was significant difference in SDM/SWI ratio before thrombolysis between the two groups in prognosis degree(P<0.05).The two variables were analyzed by Spearman linear correlation analysis(r=0.683,P<0.05).Conclusion SWI cortical vessel sign can be used to evaluate the prognosis of rt-PA intravenous thrombolysis in middle cerebral artery infarction,the SDM/SWI ratio was positively correlated with prognosis.

关 键 词：SWI皮质血管征 缺血半暗带 RT-PA 静脉溶栓 

分 类 号：R743.3[医药卫生—神经病学与精神病学]