脑桥旁正中梗死急性期早期神经功能恶化的影响因素  

Predictive factors of early neurological deterioration in acute paramedian pontine infarction

作　　者：李彩燕 陈名峰[1] Li Caiyan;Chen Mingfeng(Department of Neurology,Fujian Provincial Hospital South Branch,Fuzhou 350028,China)

机构地区：[1]福建省立医院南院神经科,福州350028

出　　处：《创伤与急诊电子杂志》2022年第4期220-224,共5页Journal of Trauma and Emergency(Electronic Version)

摘　　要：目的探讨脑桥旁正中梗死(paramedian pontine infarction,PPI)急性期早期神经功能恶化(early neurological deterioration,END)的影响因素。方法收集2015年6月1日至2021年12月31日福建省立医院南院神经内科发病48h内经颅脑磁共振确诊的53例PPI患者的临床资料,根据患者发病后7d内美国国立卫生研究院脑卒中量表(national institute of health stroke scale,NIHSS)评分,增加≥2分或运动障碍评分增加≥1分定为END,出现END为观察组,未出现为对照组,分析两组临床及病灶特点。结果53例PPI患者中发生急性期END11例(20.8%),未发生END 42例(79.2%)。单因素分析显示:观察组的糖尿病患病率(81.8%)高于对照组(42.9%),观察组的病灶面积[1.71(1.03,2.31)cm^(2)]较对照组[1.31(0.59,1.63)cm^(2)]大,差异均有统计学意义(P<0.05)。Logistic回归分析发现,糖尿病(OR=35.64,95%CI:1.27~1003.37,P=0.04)和病灶面积(OR=7.70,95%CI:1.59~37.22,P=0.01)是急性期END发生的独立危险因素。结论糖尿病和病灶面积可作为PPI急性期发生END的预测指标。Objective To investigate the predictive factors of early neurological deterioration(END)in acute paramedian pontine infarction(PPI).Method We collected the clinical data of 53 patients with new PPI diagnosed by magnetic resonance imaging(MRI)within 48 hours of symptom onset from the department of neurology in South Hospital of Fujian Province hospital from June 1,2015 to December 31,2021.END was defined as an incremental increase in the NIHSS score by≥1 point in motor power or≥2 points in the total score within the first week after admission.According to whether they had END,all patients were divided into the observation group and the control group,and their clinical and imaging characteristics were analyzed.Result There were 11 patients(20.8%)with END in the observation group and 42(79.2%)in the control group.Univariate analysis showed that the prevalence of diabetes in the observation group(81.8%)was higher than that in the control group(42.9%),and the infarct area of the observation group[1.71(1.03,2.31)cm^(2)]was larger than that of the control group[1.31(0.59,1.63)cm^(2)].The differences were statistically significant(P<0.05).Logistic regression analysis showed that diabetes mellitus(OR=35.64,95%CI:1.27-1003.37,P=0.04),and infarct area(OR=7.70,95%CI:1.59-37.22,P=0.01)were independent risk factors for END of PPI.Conclusion Diabetes and infarct area are predictors of END in PPI.

关 键 词：脑桥旁正中梗死 早期神经功能恶化 糖尿病 血糖 梗死面积 

分 类 号：R743.33[医药卫生—神经病学与精神病学]