孤立性皮质下梗死病灶位置与早期神经功能恶化的相关性研究  

Study on the correlation between the location and early neurological deterioration in isolated subcortical infarction

作　　者：李倩[1] 曲明卫[1] 王宁宁 王立敏 范桂梅[1] 杨潮萍[1] LI Qian;QU Mingwei;WANG Ningning(Cangzhou Central Hospital,Cangzhou 061000,China)

机构地区：[1]沧州市中心医院神经内科,河北沧州061000

出　　处：《中风与神经疾病杂志》2022年第12期1074-1077,共4页Journal of Apoplexy and Nervous Diseases

基　　金：2021年度河北省卫生健康委科研基金项目(20211206)。

摘　　要：目的探讨孤立性皮质下梗死的病灶位置与早期神经功能恶化(END)的相关性。方法收集我院入院诊断为孤立性皮质下梗死的患者,依据梗死位置不同将患者分为近端梗死组和远端梗死组。在入院当天及之后3 d内对患者采用美国国立卫生研究院卒中量表(NIHSS)进行神经功能缺损程度评估,若入院后72 h内NIHSS评分增加2分或以上,我们称其发生了END。比较这两组患者的基本资料以及END的发生率,最后筛选出初期预测END的独立危险因素。结果符合入组标准的有422例,其中239例近端梗死组中有68例发生了END,183例远端梗死组中有13例发生了END。END组的年龄、男性比例、低密度脂蛋白胆固醇水平、卒中史、近端梗死、载体动脉狭窄率均显著高于非END组,且具有统计学意义。Logistic回归分析显示,年龄、男性、卒中史、近端梗死、载体动脉狭窄是END的独立危险因素。结论近端梗死的孤立性皮质下梗死患者更易发生END,应引起临床上的关注。Objective To study the relationship between infarct location and early neurological deterioration(END)in isolated subcortical infarctions.Methods We collected patients who were admitted with a diagnosis of isolated subcortical infarction.According to their infarct location,patients were divided into proximal infarct group and distal infarct group.National Institutes of Health Stroke Scale(NIHSS)score was used to assess the degree of neurological impairment in both groups on the day of admission and within 3 days after admission.If the NIHSS score increased by 2 points or more within 72 hours after admission,END was considered.Baseline data and the incidence of END were compared between groups.Finally,We screened the independent risk factors for early prediction of END.Results A total of 422 cases were collected,68 of 239 cases with proximal infarct and 13 of 183 cases with distal infarct developed END.There were statistically significant differences in age,male,LDL,history of stroke,proximal infarct and carrier artery stenosis in END,compared with non-END.Logistic regression analysis showed that age,male,history of stroke,proximal infarct and carrier artery stenosis were independent risk factors for END.Conclusion Patients with proximal infarct are more likely to develop END in isolated subcortical infarctions,which should arouse clinical attention.

关 键 词：孤立性皮质下梗死 病灶位置 早期神经功能恶化 

分 类 号：R743.33[医药卫生—神经病学与精神病学]