【摘要】：目的:探討豆紋動脈區(qū)(LSA)分支動脈粥樣硬化疾病(BAD)和腔隙性腦梗死(LI)早期神經惡化(END)危險因素及預后。方法:收集2013年03月至2016年10月期間住院,經頭顱MRI檢查證實存在LSA急性腦梗死患者76例。按頭顱MRI結果分為BAD組(40例),LI組(36例)。入院72 h內根據美國國立衛(wèi)生研究院卒中量表(NIHSS)評分變化劃分為END組(28例),非END組(48例)。收集基線資料、臨床資料,進行比較。結果:(1)BAD組糖尿病史、HbA1C、Hcy、入院時NIHSS、偏癱發(fā)生率、發(fā)病1個月mRS評分均顯著高于LI組;(2)發(fā)病3個月mRS評分BAD組與LI組之間無顯著性差異;(3)BAD組與LI組比較更易發(fā)生END;(4)BAD組中END患者糖尿病史、HbA1C、Hcy、入院時NIHSS、發(fā)病1個月mRS評分均高于非END患者;(5)多因素Logistic回歸分析示HbA1C、Hcy是BAD組END的危險因素。結論:LSA供血區(qū)BAD患者病情重,易進展,HbA1C、Hcy是END的危險因素;BAD組及LI組患者3個月預后均較好。
[Abstract]:Objective: to investigate the risk factors and prognosis of early nerve deterioration (END) in patients with (LSA) branch atherosclerosis and lacunar cerebral infarction (LI). Methods: from March 2013 to October 2016, 76 patients with acute cerebral infarction of LSA were confirmed by cranial MRI examination. According to the results of cranial MRI, the patients were divided into BAD group (40 cases) and Li group (36 cases). Within 72 hours of admission, the patients were divided into END group (28 cases) and non-END group (48 cases) according to the changes of (NIHSS) score of stroke scale of the National Institutes of Health. The baseline data and clinical data were collected and compared. Results: (1) in BAD group, the history of diabetes mellitus and the incidence of NIHSS, hemiplegia were observed. (2) there was no significant difference in mRS score between BAD group and LI group at 3 months after onset, (3) END; (4) BAD group and LI group were more likely to develop HbA1CU HcyA in END group, and mRS evaluation on NIHSS, 1 month after hospitalization in END; (4) BAD group was more likely to occur in END; (4) BAD group than in END; (4) BAD group. (5) multivariate Logistic regression analysis showed that HbA1C,Hcy was the risk factor of END in BAD group. Conclusion the patients with BAD in the blood supply area of W1 LSA are in a serious condition, and HbA1C- Hcy is a risk factor for END. The prognosis of patients in bad group and LI group is better than that in LI group in 3 months.
【作者單位】： 江蘇省連云港市第二人民醫(yī)院神經內科;
【基金】：連云港市“科教興衛(wèi)工程”青年科技項目(QN1408)
【分類號】：R743.33

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