Little is known about dysphagia after pontine infarction. In this study, we evaluated the incidence of dysphagia after isolated pontine infarction and identified the predictive factors for the occurrence of dysphagia....Little is known about dysphagia after pontine infarction. In this study, we evaluated the incidence of dysphagia after isolated pontine infarction and identified the predictive factors for the occurrence of dysphagia. A total of 146 patients were included in this study. All patients underwent clinical testing for dysphagia within 1 day after admission and at the time of discharge. We compared the incidence of dysphagia between patients with unilateral pontine infarction and those with bilateral pontine infarction. To evaluate the functional status of patients, we investigated their initial modified Rankin Scale(mRS) score and initial National Institutes of Health Stroke Scale(NIHSS) score within 1 day of admission. Of 146 patients, 50(34.2%) had dysphagia initially within 1 day after admission. At the second evaluation at the time of discharge, dysphagia was diagnosed in 24 patients(16.4%). Patients with bilateral pontine infarction were more likely to present with dysphagia. In addition, clinical severity(in terms of mRS and NIHSS scores) was identified as a predictor of dysphagia in patients with cerebral infarction(multiple binary logistic regression analysis, mRS: P = 0.011, NIHSS: P = 0.004). Dysphagia frequently occurs in patients with isolated pontine infarction. Clinicians should pay particular attention to the occurrence of dysphagia, especially in patients with bilateral pontine infarction or high functional disability.展开更多
目的探讨孤立性脑桥梗死的临床和影像学特征以及早期运动障碍进展(progressive motor deficits,PMD)和短期预后的影响因素。方法对初次发病24h内入院的86例孤立性脑桥梗死患者进行回顾性分析,根据梗死灶最大直径和部位分为脑桥旁正...目的探讨孤立性脑桥梗死的临床和影像学特征以及早期运动障碍进展(progressive motor deficits,PMD)和短期预后的影响因素。方法对初次发病24h内入院的86例孤立性脑桥梗死患者进行回顾性分析,根据梗死灶最大直径和部位分为脑桥旁正中梗死(pararl-ledian pontine infarction,PPI)和脑桥腔隙性梗死(lacunar pontine infarction,LPI),根据早期PMD情况分为PMD组和无PMD组,根据出院时改良Rankin量表(modified Rankin Scale,mRS)评分分为转归不良组(mRS评分〉2分)和转归良好组(mRS评分≤2分),对不同病例组的临床和影像学特征进行比较。结果PPI组(n=35)高脂血症(57.14%对33.33%;X^2=4.80,P=0.028)、偏瘫(97.14%对72.55%;X^2=8.718,P=0.003)、基底动脉狭窄(45.71%对17.65%;X^2=7.930,P=0.005)和出院时转归不良(54.29%对31.37%;X^2=4.515,P=0.034)患者构成比以及基线美国国立卫生研究院卒中量表(National Institutes of Health Strokescale,NIHSS)评分[(6.00±2.39)分对(4.61±3.41)分;t=2.087,P=0.040]均显著性高于LPI组(n=51)。PMD组(n=22)基线舒张压水平[(97.82±15.61)minHg对(89.55±12.23)mmHg,1mmHg=0.133kPa;t=2.258,P=0.031]以及PPI(63.64%对32.81%;X^2=6.445,P=0.011)和基底动脉狭窄(59.10%对18.75%;X^2=12.922,P=0.000)的构成比均显著性高于无PMD组(n=64)。转归不良组(n=35)基线NIHSS评分[(6.80±2.63)分对(3.73±2.55)分;t=5.426,P=0.000]和空腹血糖水平[(9.40±5.15)mmol/L对(6.56±2.69)mmol/L;t=2.985,P=0.004]以及PPI患者构成比(54.29%对31.37%;X2=4.515,P=0.034)均显著性高于转归良好组(n=51)。多变量logistic回归分析显示,基底动脉狭窄是PPI发病[优势比(oddsratio,OR)3.801,95%可信区间(confi展开更多
文摘Little is known about dysphagia after pontine infarction. In this study, we evaluated the incidence of dysphagia after isolated pontine infarction and identified the predictive factors for the occurrence of dysphagia. A total of 146 patients were included in this study. All patients underwent clinical testing for dysphagia within 1 day after admission and at the time of discharge. We compared the incidence of dysphagia between patients with unilateral pontine infarction and those with bilateral pontine infarction. To evaluate the functional status of patients, we investigated their initial modified Rankin Scale(mRS) score and initial National Institutes of Health Stroke Scale(NIHSS) score within 1 day of admission. Of 146 patients, 50(34.2%) had dysphagia initially within 1 day after admission. At the second evaluation at the time of discharge, dysphagia was diagnosed in 24 patients(16.4%). Patients with bilateral pontine infarction were more likely to present with dysphagia. In addition, clinical severity(in terms of mRS and NIHSS scores) was identified as a predictor of dysphagia in patients with cerebral infarction(multiple binary logistic regression analysis, mRS: P = 0.011, NIHSS: P = 0.004). Dysphagia frequently occurs in patients with isolated pontine infarction. Clinicians should pay particular attention to the occurrence of dysphagia, especially in patients with bilateral pontine infarction or high functional disability.
文摘目的探讨孤立性脑桥梗死的临床和影像学特征以及早期运动障碍进展(progressive motor deficits,PMD)和短期预后的影响因素。方法对初次发病24h内入院的86例孤立性脑桥梗死患者进行回顾性分析,根据梗死灶最大直径和部位分为脑桥旁正中梗死(pararl-ledian pontine infarction,PPI)和脑桥腔隙性梗死(lacunar pontine infarction,LPI),根据早期PMD情况分为PMD组和无PMD组,根据出院时改良Rankin量表(modified Rankin Scale,mRS)评分分为转归不良组(mRS评分〉2分)和转归良好组(mRS评分≤2分),对不同病例组的临床和影像学特征进行比较。结果PPI组(n=35)高脂血症(57.14%对33.33%;X^2=4.80,P=0.028)、偏瘫(97.14%对72.55%;X^2=8.718,P=0.003)、基底动脉狭窄(45.71%对17.65%;X^2=7.930,P=0.005)和出院时转归不良(54.29%对31.37%;X^2=4.515,P=0.034)患者构成比以及基线美国国立卫生研究院卒中量表(National Institutes of Health Strokescale,NIHSS)评分[(6.00±2.39)分对(4.61±3.41)分;t=2.087,P=0.040]均显著性高于LPI组(n=51)。PMD组(n=22)基线舒张压水平[(97.82±15.61)minHg对(89.55±12.23)mmHg,1mmHg=0.133kPa;t=2.258,P=0.031]以及PPI(63.64%对32.81%;X^2=6.445,P=0.011)和基底动脉狭窄(59.10%对18.75%;X^2=12.922,P=0.000)的构成比均显著性高于无PMD组(n=64)。转归不良组(n=35)基线NIHSS评分[(6.80±2.63)分对(3.73±2.55)分;t=5.426,P=0.000]和空腹血糖水平[(9.40±5.15)mmol/L对(6.56±2.69)mmol/L;t=2.985,P=0.004]以及PPI患者构成比(54.29%对31.37%;X2=4.515,P=0.034)均显著性高于转归良好组(n=51)。多变量logistic回归分析显示,基底动脉狭窄是PPI发病[优势比(oddsratio,OR)3.801,95%可信区间(confi