孤立性脑桥梗死早期神经功能恶化的预测因素分析  

Analysis of predictors of early neurological deterioration in isolated pontine infarction

作　　者：伍文波 笱玉兰[2] WU Wenbo;GOU Yulan(School of Medicine,Jianghan University,Wuhan 430056;Neurology Department,Wuhan No.1 Hospital,Wuhan 430022,China)

机构地区：[1]江汉大学医学部,湖北武汉430056 [2]武汉市第一医院神经内科,湖北武汉430022

出　　处：《临床医学研究与实践》2025年第10期26-29,共4页Clinical Research and Practice

摘　　要：目的分析孤立性脑桥梗死早期神经功能恶化(END)的预测因素。方法收集武汉市第一医院2020年11月至2022年10月符合纳排标准的153例孤立性脑桥梗死患者为研究对象,根据发病后7 d内美国国立卫生研究院脑卒中量表(NIHSS)或运动功能评分将患者分为END组和非END组。收集两组患者的人口统计学特征、临床及影像学资料;采用Logistic回归分析评估孤立性脑桥梗死发生END的独立预测因素,并绘制受试者工作特征(ROC)曲线图。结果153例孤立性脑桥梗死患者中,41例发生END,占比26.80%;112例未发生END,占比73.20%。两组的性别、年龄、高血压、高脂血症、高同型半胱氨酸血症、冠心病史、脑卒中史、吸烟史、静脉溶栓占比比较,差异无统计学意义(P>0.05);END组的糖尿病占比、入院时NIHSS评分高于非END组,差异具有统计学意义(P<0.05)。两组的梗死灶位置、基底动脉中重度狭窄及大动脉闭塞性疾病(LAOD)占比比较,差异无统计学意义(P>0.05);END组的梗死灶面积及基底动脉穿支动脉疾病(BABD)占比显著高于非END组,小动脉病变(SAD)占比低于非END组(P<0.05)。多因素二元Logistic回归分析结果显示,入院时NIHSS评分、梗死灶面积是孤立性脑桥梗死发生END的独立预测因素(P<0.05)。ROC曲线分析结果显示,入院时NIHSS评分联合梗死灶面积预测END的灵敏度为85.40%,特异度为83.00%,曲线下面积(AUC)为0.887。结论BABD是孤立性脑桥梗死发生END最常见的类型,入院时NIHSS评分、梗死灶面积与孤立性脑桥梗死END有关,可能是END的有效预测因素。Objective To analyze the predictors of early neurological deterioration(END)in isolated pontine infarction.Methods A total of 153 patients with isolated pontine infarction who met the inclusion and exclusion criteria from November 2020 to October 2022 in Wuhan No.1 Hospital were collected as the research objects.According to the National Institutes of Health Stroke Scale(NIHSS)or motor function score within 7 d after onset,the patients were divided into END group and non-END group.The demographic characteristics,clinical and imaging data of the two groups were collected.Logistic regression analysis was used to evaluate the independent predictors of END in isolated pontine infarction,and the receiver operating characteristic(ROC)curve was drawn.Results Of the 153 patients with isolated pontine infarction,41 had END,accounting for 26.80%,and 112 had no END,accounting for 73.20%.There were no significant differences in gender,age,hypertension,hyperlipidemia,hyperhomocysteinemia,history of coronary heart disease,history of stroke,smoking history and proportion of intravenous thrombolysis between the two groups(P>0.05);the proportion of diabetes and NIHSS score at admission in the END group were higher than those in the non-END group,and the differences were statistically significant(P<0.05).There were no significant differences in the location of infarction,the proportion of moderate to severe basilar artery stenosis and large-artery-occlusive disease(LAOD)between the two groups(P>0.05);the infarct size and the proportion of basilar artery branch disease(BABD)in the END group were significantly higher than those in the non-END group,and the proportion of small artery disease(SAD)was lower than that in the non-END group(P<0.05).Multivariate binary Logistic regression analysis showed that NIHSS score at admission and infarct size were independent predictors of END in isolated pontine infarction(P<0.05).The results of ROC curve analysis showed that the sensitivity of NIHSS score at admission combined with infarct size t

关 键 词：孤立性脑桥梗死 早期神经功能恶化 预测因素 

分 类 号：R541.4[医药卫生—心血管疾病]