单发性皮质下梗死患者早期神经功能恶化的预测因素  

Predictive factors of early neurological deterioration in patients with single subcortical infarction

作　　者：晏美娟 邵礼晖 Yan Meijuan;Shao Lihui(Department of Neurology,Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University,Xuzhou 221000,China)

机构地区：[1]徐州医科大学附属徐州市立医院神经内科,徐州221100 [2]新沂市中医院,徐州221400

出　　处：《国际脑血管病杂志》2024年第1期22-26,共5页International Journal of Cerebrovascular Diseases

基　　金：徐州医科大学附属医院科技发展基金(XYFY2020034);2021徐州市基础研究计划面上项目(KC21063)。

摘　　要：目的探讨单发性皮质下梗死(single subcortical infarction,SSI)患者早期神经功能恶化(early neurological deterioration,END)的预测因素。方法回顾性连续纳入2016年1月至2021年12月在发病12 h内入住徐州医科大学附属市立医院神经内科的SSI患者。收集并比较END组和非END组临床和影像学资料。采用多变量logistic回归分析确定END的独立危险因素。结果共纳入1060例SSI患者,其中268例(25.28%)发生END。END组与非END组弥散加权成像显示的梗死灶累及内囊、SSI分类、梗死灶最大直径及分类和梗死灶层数方面差异有统计学意义(P均<0.05)。多变量logistic回归分析显示,梗死灶累及内囊[优势比(odds ratio,OR)1.52,95%置信区间(confidence interval,CI)1.271.96;P=0.015]、梗死灶最大直径(OR 1.33,95%CI 1.121.42;P=0.023)、近端SSI(OR 1.49,95%CI 1.281.92;P=0.018)以及梗死灶层数(与1层相比,3层:OR 15.01,95%CI 4.1212.45,P=0.013;≥4层,OR 15.42,95%CI 5.6718.43,P=0.004)是END的独立危险因素。结论弥散加权成像显示的梗死灶累及内囊、梗死灶直径较大、近端SSI以及梗死灶≥3层可能是SSI患者发生END的预测因素。ObjectiveTo investigate the predictive factors of early neurological deterioration(END)in patients with single subcortical infarction(SSI).MethodsConsecutive patients with SSI within 12 h of onset admitted to the Department of Neurology,Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University from January 2016 to December 2021 were included retrospectively.The clinical and imaging data of the END and non-END groups were collected and compared.Multivariate logistic regression analysis was used to determine the independent risk factors for END.ResultsA total of 1060 patients with SSI were included,of which 268(25.28%)developed END.There were statistically significant differences in the infarct involving internal capsule on diffusion-weighted imaging,SSI classification,maximum diameter and classification of the infarcts,and the number of infarct layers between the END group and the non-END group(all P<0.05).Multivariate logistic regression analysis showed that the infarct involved the internal capsule(odds ratio[OR]1.52,95%confidence interval[CI]1.27-1.96;P=0.015),the maximum diameter of the infarct(OR 1.33,95%CI 1.12-1.42;P=0.023),proximal SSI(OR 1.49,95%CI 1.28-1.92;P=0.018),and the number of infarct layers(compared to 1 layer,3 layers:OR 15.01,95%CI 4.12-12.45,P=0.013;≥4 layers:OR 15.42,95%CI 5.67-18.43,P=0.004)were independent risk factors for END.ConclusionInfarct involved internal capsule on diffusion-weighted imaging,larger diameter of the infarct,proximal SSI,and≥3 layers of infarct may be predictive factors of the occurrence of END in patients with SSI.

关 键 词：卒中 脑梗死 疾病恶化 磁共振成像 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]