摘要
目的比较出院时神经功能缺损程度不同的脑干梗死(BSI)患者的临床及影像特点,分析新发孤立BSI患者出院时症状较重的相关因素。方法纳入中国颅内动脉粥样硬化研究(ICAS)中在发病后7 d内、年龄18~80岁的新发孤立BSI患者共302例。收集患者的临床和影像资料并评估,分析孤立BSI患者的临床和影像学因素对于出院时神经功能的影响。结果两例脑桥梗死患者出院时信息不全,故一共分析了300例患者的出院信息。多因素Logistic回归分析显示,BSI患者入院NIHSS评分≥3分、首发症状有眩晕、病灶体积>0.5 ml、大动脉粥样硬化(LAD)病因分型是出院时神经功能缺损程度较重(NIHSS评分≥4分)的危险因素(均P<0.05)。结论对于梗死体积较大、LAD类型的BSI患者,早期抗栓及他汀治疗干预和及时的二级预防对其康复非常必要。
Objective To compare the clinical and imaging characteristics of brainstem infarction(BSI)patients with different degrees of neurological impairment at discharge and analyzed the related factors of severe neurological impairment when newly isolated BSI patients were discharged.Methods A total of 302 newly isolated BSI patients from Intracranial Atherosclerosis Study in china(ICAS),who were aged 18-80 years and within 7 d after onset were erolled.The clinical and imaging data of the patients were collected.The effect of clinical and imaging factors on neurological function of patients with isolated BSI at discharge were analyzed.Results The information of two patients with pontine infarction was in complete,so a total of 300 patients’discharge information was analyzed.Multivariate Logistic regression showed that NIHSS score≥4 points,initial symptoms of vertigo,lesion volume>0.5 ml and etiological subtypes of large artery disease(LAD)were risk factors for severe neurological deficits(NIHSS score≥4)(all P<0.05).Conclusion Early antithrombotic and statin therapy as well as timely secondary prevention are very necessary for the rehabilitation of BSI patients with large infarct size and etiological subtypes of LAD.
作者
赵凤丽
刘宏顺
ZHAO Feng-li;LIU Hong-shun(Deparment of Neurology,the Second Hospital of Baoding City,Baoding 071051,China)
出处
《临床神经病学杂志》
CAS
2021年第3期187-193,共7页
Journal of Clinical Neurology
关键词
脑干梗死
大动脉病变
预后
颅内动脉粥样硬化
穿支动脉
brainstem infarction
large artery disease
prognosis
intracranial arteriosclerosis
perforators
