论文部分内容阅读
目的:探讨豆纹动脉区(LSA)分支动脉粥样硬化疾病(BAD)和腔隙性脑梗死(LI)早期神经恶化(END)危险因素及预后。方法:收集2013年03月至2016年10月期间住院,经头颅MRI检查证实存在LSA急性脑梗死患者76例。按头颅MRI结果分为BAD组(40例),LI组(36例)。入院72 h内根据美国国立卫生研究院卒中量表(NIHSS)评分变化划分为END组(28例),非END组(48例)。收集基线资料、临床资料,进行比较。结果:(1)BAD组糖尿病史、HbA1C、Hcy、入院时NIHSS、偏瘫发生率、发病1个月mRS评分均显著高于LI组;(2)发病3个月mRS评分BAD组与LI组之间无显著性差异;(3)BAD组与LI组比较更易发生END;(4)BAD组中END患者糖尿病史、HbA1C、Hcy、入院时NIHSS、发病1个月mRS评分均高于非END患者;(5)多因素Logistic回归分析示HbA1C、Hcy是BAD组END的危险因素。结论:LSA供血区BAD患者病情重,易进展,HbA1C、Hcy是END的危险因素;BAD组及LI组患者3个月预后均较好。
Objective: To investigate the risk factors and prognosis of early neurological deterioration (END) in branch artery atherosclerosis (BAD) and lacunar infarction (LI) in lentiginous artery region (LSA). Methods: The hospitalized patients were collected from March 2013 to October 2016 and 76 patients with acute cerebral infarction (LSA) confirmed by head MRI were identified. According to cranial MRI results were divided into BAD group (40 cases), LI group (36 cases). Within 72 h of admission, the END group (28 cases) and the non-END group (48 cases) were divided according to the National Institutes of Health Stroke Scale (NIHSS) score changes. Collect baseline data, clinical data, and compare. Results: (1) The history of diabetes, HbA1C, Hcy, the incidence of NIHSS, the incidence of hemiplegia and the incidence of mRS at 1 month after admission in BAD group were significantly higher than those in LI group. (2) The mRS score at 3 months in BAD group was significantly higher than that in LI group There was no significant difference between BAD group and LI group. (4) The history of diabetes, HbA1C, Hcy, NIHSS admission and mRS score at 1 month in BAD group were higher than those in non-END group ; (5) Multivariate Logistic regression analysis showed that HbA1C and Hcy were risk factors of END in BAD group. Conclusions: Patients with BAD in LSA donor area have severe and easy progression, and HbA1C and Hcy are risk factors for END. The patients in BAD group and LI group have better prognosis at 3 months.