摘要
[目的]探讨陈旧性腔隙性脑梗死(LI)对初发脑梗死患者预后判断的影响。[方法]回顾性分析本院收治的145例存在陈旧性LI病史的初发脑梗死患者的临床资料。根据陈旧性LI情况病灶的数目分为A组(病灶≤4个)、B组(病灶>4个)。比较两组脑微出血分级、脑白质病变程度分级、颅内动脉钙化评分。对影响患者预后的因素进行回归分析。[结果]与A组比较.B组患者中3級脑微出血的比例明显增多(P<0.05),2.3级脑白质病变的比例明显增多(P<0.05),颅内动脉钙化评分3分以上的比例明显增多(P<0.05).Spearman分析显示陈旧性Ll病灶数目与脑微出血分级程度,脑白质病变程度和颅内动脉钙化评分呈正相关(Rs=0.735,0.774,0.695,P<0.05)。多因素COX回顾分析显示:陈旧性LI病灶数目、脑微出血分级、脑白质病变程度分级、颅内动脉钙化评分、出院后未使用抗血小板药、出院后未使用他汀类药物是初发脑梗死患者预后的独立危险因素(P<0.05)。[结论]陈旧性LI病灶数目与脑微血管病变、脑白质病变程度和颅内动脉钙化评分密切相关,且都是初发脑梗死患者预后的独立危险因素.
[Objective]To investigate the efect of old lacunar infarction(LI)on the prognosis of patients with primary cerebral infaretion.[Methods]The clinical data of 145 patients with primary cerebral infarction with old LI history were retrospectively analyzed.According to the number of old li.the patients were divided into group A(lesions≤4)and group B(lesions>4).The grade of cerebral microbleeds,white malter lesions and intracranial artery caleification were compared between the two groups.The factors influencing the progno-sis were analyzed by regression analysis.[Results]Compared with the group A,the proportion of grade 3 cere-bral microbleeds in the group B was significantly increased(P<0.05).the proportion of grade 2 and 3 white matter lesions was significantly increased(P<0.05).and the proportion of intracranial artery caleificaion score above 3 points was significantly increased(P<0.05).Spearman analysis showed that the number of old LI lesions was positively correlated with the grade of cerebral microbleeds.the degree of white matter lesions and the score of intracranial artery caleification(Rs=0.735,0.774,0.695,P<0.05).Multivariate C0X regres-sion analysis showed that the number of old LI lesions.grade of cerebral microbleeds.grade of white matter lesions,intracranial artery caleification score,no use of antiplatelet drugs after discharge and no use of statins were independent risk factors for the prognosis of paients with primary cerebral infarction(P<0.05).[Con-clusion]The number of old LI lesions is closely related to cerebral microvascular lesions,white matter lesions and intracranial artery caleification score,and are independent risk factors for the prognosis of patients with in-itial cerebral infarction。
作者
蔡瑞煜
王海萍
白蓓蓓
CAI Rui-yu;WAHG Hai-ping;BAI Bei-bei(The Affiliuled Hospital of Qingdao,Qingduo,shandong,266000)
出处
《医学临床研究》
CAS
2020年第9期1333-1335,1339,共4页
Journal of Clinical Research
关键词
脑梗死
预后
Brain Infaretion
Prognosis
