本文選題：卒中預(yù)后　切入點：顳前動脈　出處：《醫(yī)學(xué)研究生學(xué)報》2016年11期

【摘要】：目的顳前動脈是大腦中動脈第一個主要分支血管。在急性大腦中動脈(middle cerebral artery,MCA)閉塞患者中,其可提供潛在血流,繼而改變腦組織壞死進(jìn)程。文中旨在探討通過分析急性動脈粥樣硬化性MCA的M1段(middle cerebral artery-M1 segment,MCA-M1)閉塞后顳前動脈存在與梗死模式及梗死體積的改變,并探討其對患者臨床預(yù)后的影響。方法選取南京卒中注冊系統(tǒng)中2007年1月至2013年12月,因首發(fā)缺血性卒中且影像學(xué)檢查提示為動脈粥樣硬化性MCA閉塞的患者116例。同時依據(jù)有無顳前動脈分為2組:55例患者存在顳前動脈(顳前動脈存在組),61例患者顳前動脈缺失(顳前動脈缺失組)。于入院期間均完成頭顱MRI及血管學(xué)檢查。對2組進(jìn)行臨床基礎(chǔ)資料的比較,采用Alberta卒中項目早期CT評分方式分析組間病灶面積的差異,并采用改良Rankin量表(modified rankinscale,mRS)評估患者3個月功能預(yù)后。最后采用多因素Logistic回歸分析3個月預(yù)后良好(mRS≤2)的獨立預(yù)測因素。結(jié)果顳前動脈存在組入院國立衛(wèi)生院神經(jīng)功能評分(National Institute of Health Stroke Scale,NIHSS)、出院NIHSS評分較顳前動脈缺失組顯著降低,且ASPECTS評分≥7分、mRS評分≤2分例數(shù)顯著升高(P0.05)。顳前動脈存在組多區(qū)域病灶梗死、穿通支動脈區(qū)域梗死的發(fā)生率明顯低于顳前動脈缺失組(34.6%vs 53.1%,38.5%vs 57.8%,P0.05);mRS評分≤2發(fā)生率明顯高于顳前動脈缺失組(73.1%vs 35.9%,P0.001)。55例(47.4%)患者3個月功能預(yù)后良好,多因素logistic回歸分析顯示顳前動脈存在(OR=0.188,95%CI:0.062~0.572)、入院NIHSS評分(OR=1.578,95%CI:1.326~1.878)是患者3個月預(yù)后良好的獨立預(yù)測因素。結(jié)論顳前動脈存在能夠減小急性動脈粥樣硬化性MCA-M1段閉塞患者梗死體積,改善患者臨床功能預(yù)后。
[Abstract]:Objective the anterior temporal artery is the first major branch of the middle cerebral artery.In patients with acute middle middle cerebral artery occlusion (MCA), it provides potential blood flow and changes the progression of brain necrosis.The purpose of this study was to investigate the changes of anterior temporal artery (ACA) pattern and infarct volume after acute atherosclerotic MCA (M1) middle cerebral artery-M1 segmenting (MCA-M1) occlusion, and to explore its effect on clinical prognosis.Methods from January 2007 to December 2013, 116 patients with atherosclerotic MCA occlusion were selected from Nanjing Stroke Registration system.At the same time, the anterior temporal artery was divided into two groups according to the presence or absence of anterior temporal artery. There were 55 patients with anterior temporal artery (group A) and 61 patients with loss of anterior temporal artery (absence of anterior temporal artery).Cranial MRI and vascularization were performed during admission.The basic clinical data of the two groups were compared. The difference of lesion area between the two groups was analyzed by Alberta stroke project early CT scoring method, and the 3-month functional prognosis was evaluated by modified Rankin scale scale (modified Rankin scale).Finally, multivariate Logistic regression analysis was used as an independent predictor of good prognosis in 3 months (Mrs 鈮，

本文編號：1708421