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孤立性脑桥梗死急性期不同形态学部位与神经功能缺损进展的相关性分析

2017-05-10王开王海军

中国医学创新 2017年11期
关键词:神经功能缺损急性期

王开+王海军

【摘要】 目的:分析新發孤立性脑桥梗死不同的形态学部位与患者急性期发生神经功能缺损进展的相关性。方法:对2012年2月-2016年2月收治的新发孤立性脑桥梗死168例患者临床资料进行回顾性分析,患者均经MRI确诊,按患者是否出现急性期的神经功能缺损进展分成进展组和未进展组,分析两组患者临床特征、实验室指标、形态学部位差别及不同的形态学部位与神经功能缺损进展相关性。结果:新发孤立性脑桥梗死168例患者中,进展组占26.8%(45/168),未进展组占73.2%(123/168)。与未进展组比较,进展组在女性患者[57.8%(26/45) vs 43.1%(53/123), x2=5.137]、吸烟[13.3%(6/45) vs 26.8%(33/123), x2=5.092]、住院时间[(22.9±7.1)d vs (16.9±7.3)d,t=6.137]、短期预后不良比例[77.8%(35/45) vs 33.3%(41/123), x2=31.812]、脑桥下部梗死率[44.4%(20/45) vs 30.1%(37/123), x2=6.038],差异均有统计学意义(P<0.05)。经Logistic回归分析提示下部梗死是该类患者急性期出现神经功能缺损进展独立的危险因素[OR=1.953,95%CI(1.092,3.535),P=0.029]。结论:新发孤立性脑桥梗死患者形态学中下部梗死可以作为预测急性期出现神经功能缺损进展的一个指标。

【关键词】 脑桥梗死; 神经功能缺损; 急性期; 弥散加权成像

Relationship between Different Topographic Location and Neurological Deterioration in Acute New Isolated Pontine Infarction/WANG Kai,WANG Hai-jun.//Medical Innovation of China,2017,14(11):001-004

【Abstract】 Objective:To discuss the relationship between different topographic location and neurological deterioration(ND)in patients with acute new isolated pontine infarction.Method:168 patients with acute new isolated pontine infarction from February 2012 to February 2016 and identified by diffusion weighted imaging(OWI),were included for retrospective review.Patients were divided into two groups according to their clinical symptoms:the patients with ND group and thepatients without ND group.The correlations of ND with risk factors,laboratory examination results,clinical manifestations and different topographic locations were analysed by statistical tests.Rusult:Among 168 patients,26.8%(45/168)were diagnosed with ND,73.2%(123/168) were diagnosed without ND.Univariate analysis showed that there were differences in female ratio[57.8%(26/45) vs 43.1%(53/123), x2=5.137],smoking ratio[13.3%(6/45)vs 26.8%(33/123),x2=5.092],mean length of hospital stay[(22.9±7.1)d vs (16.9±7.3)d,t=6.137],ratio of worse short-term clinical outcomes[77.8%(35/45) vs 33.3%(41/123),x2=31.812] and ratio of lower pontine infarction[44.4%(20/45) vs 30.1%(37/123),

x2=6.038] between two groups (P<0.05).Logistic regression analysis showed that lower pontine infarction was the independent risk factor of ND[OR=1.953,95%CI(1.092,3.535),P=0.029].Conclusion:Topographic location of lower pons lesions may be reliable predictor of ND in acute new isolated pontine infarction.

【Key words】 Pons infarction; Neurological deterioration; Acute stage; Diffusion weighted imaging

First-authors address:General Hospital of Fushun Mining Group,Fushun 113008,China

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