豆纹动脉放射冠区的散在脑梗死与早期神经功能恶化的相关性研究  

Study on the correlation between scattered infarction in the radial coronary infarcts of the lenticulostriate artery and early neurological deterioration

作　　者：宋良[1] 付胜奇 朱利利 石宝洋 刘海涛[1] 禹萌 张洪涛 SONG Liang;FU Shengqi;ZHU Lili(Department of Neurology,the Fifth Clinical Medical College of Henan University of Chinese Medicine(Zhengzhou People's Hospital),Zhengzhou 450003,China)

机构地区：[1]河南中医药大学第五临床医学院(郑州人民医院)神经内科,郑州450003

出　　处：《临床神经病学杂志》2024年第6期412-417,共6页Journal of Clinical Neurology

基　　金：河南省科技攻关项目(LHGJ20240880,242102310048)。

摘　　要：目的探讨豆纹动脉(LSA)放射冠区的散在脑梗死病灶与早期神经功能恶化(END)的相关性。方法回顾性纳入2018年1月至2023年9月在郑州人民医院卒中中心住院并确诊为LSA梗死的患者164例。根据梗死病灶位置分为LSA起始处单一病灶(n=103)和梗死由LSA起源并多处分散病灶(n=61)。分析两组患者的临床特征、危险因素及临床预后。结果164例患者中END49例,非END115例。单变量分析结果显示,与单一病灶相比,梗死由LSA起源并多处分散病灶出现END占比显著增多[27(55.1%)vs.22(44.9%),P<0.05],与前部型梗死相比,后部型梗死患者发生END显著增多[39(79.6%)vs.10(20.4%),P<0.05]。校正混杂因素进行多因素Logistic回归模型分析示,梗死由LSA起源并多处分散病灶(OR=3.669,95%CI:1.696~7.939,P=0.001)、后部型梗死(OR=2.303,95%CI:1.005~5.279,P=0.049)均与END的发生具有独立相关性。随访3个月,与单一病灶相比,梗死由LSA起源并多处分散病灶预后良好患者占比显著减少(45.9%vs.91.3%),临床结局预后差。结论LSA放射冠区的散在梗死灶及后部型梗死是LSA梗死发生END的独立相关危险因素,放射冠区散在梗死患者更容易发生END导致预后不良。Objective To investigate the correlation between scattered infarction in the radial coronary area of the lenticulostriate artery(LSA)and early neurological deterioration(END).Methods A total of 164 patients diagnosed with LSA infarction who were hospitalized in the Stroke Center of Zhengzhou People's Hospital from January 2018 to September 2023 were retrospectively included.According to the location of infarct lesions,the cases were divided into single lesions at the origin of the LSA(n=103)and multiple scattered lesions originating from the LSA(n=61).The clinical features,risk factors and prognosis analysis of the two groups were observed and compared.Results Among 164 patients,END occurred in 49 cases,and 115 cases did not have END.Univariate analysis results showed that compared to a single lesion,the incidence of END was significantly higher in cases where the infarction originated from the LSA and presented as multiple scattered lesions[27(55.1%)vs.22(44.9%),P<0.05].Compared to anterior infarctions,the incidence of END was significantly higher in patients with posterior infarctions[39(79.6%)vs.10(20.4%),P<0.05].Multivariate Logistic regression analysis,adjusted for confounding factors,indicated that infarctions originating from the LSA with multiple scattered lesions(OR=3.669,95%CI:1.696-7.939,P=0.001)and posterior infarctions(OR=2.303,95%CI:1.005-5.279,P=0.049)were independently associated with the occurrence of END.After 3 months of follow-up,compared with the single lesion,the proportion of patients with infarction originating from LSA and dispersed in multiple places had a significantly reduced prognosis(45.9%vs.91.3%),and the clinical outcomes were poor.Conclusions Scattered infarcts in the radiate crown area of the LSA and posterior infarctions are independent risk factors for the occurrence of END in LSA infarctions.Patients with scattered infarcts in the radiate crown area are more likely to develop END,leading to poor prognosis.

关 键 词：豆纹动脉 放射冠 病灶部位 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]