曹树刚 1徐文安 1赵昊 1郭茜 1王建 1葛婷婷1
作者信息
- 1. 230011,安徽医科大学附属合肥医院神经内科
- 折叠
摘要
Abstract
Objective To investigate the related predictors of progressive motor deficits ( PMD) after supratentorial subcortical infarcts. Methods A total of 142 patients with supratentorial subcortical infarction were enrolled prospectively. They were divided into either a PMD group or a stable group according to the disease characteristics and the motor scores of the National Institutes of Health Stroke Scale ( NIHSS). The general clinical data, laboratory parameters, neurological score, and imaging characteristics were compared between the two groups. The logistic regression analysis was used to analyze the independent risk factor for supratentorial subcortical infarcts with PMD. Results ①Of the 142 patients with supratentorial subcortical infarcts, 39 (27. 5% ) were in the PMD group. The mean time of progression was 30 ± 11 hours, and the progression in 33 patients (84. 6% ) was during the night. ②Univariate analysis revealed that the proportions of female (P - 0. 045 ) , baseline systolic blood pressure ( SBP) ≥180 mm Hg ( P = 0.000) , corona radiata infarction (P =0.000) , diameter of infarction 15-30mm (P =0.003) , unstable plaque (P = 0.001), and patients with middle cerebral artery stenosis or occlusion (P = 0.015) in the PMD group were significantly higher than those in the stable group; while the proportions of the basal gan-
glia infarction (P=0. 000) and infarct diameter < 15 mm (P = 0.000) in the stable group were significantly higher than those in the PMD group. ③Multivariate Logistic regression analysis showed that female (OR, 2.837, 95% CI 1.076-7.485; P = 0.035), baseline SBP 5≥180 mm Hg (OR, 3.509, 95% CI 1.349-9.124; P=0.010), corona radiata infarction ( OR,6. 807,95% CI 2. 446-18. 944;P = 0. 000) , unstable plaque ( OR, 3. 137 , 95% CI 1. 019-9. 657 ;P =0. 046) , and middle cerebral artery lesions ( OR 4.027 , 95% CI 1. 160-13. 976; P = 0. 028) were the independent risk factors for PMD. Conclusion The incidence of PMD in patients with supratentorial subcortical infarcts is higher. Female sex, baseline SBP ≥180mm Hg, corona radiata infarction, unstable plaque, and middle cerebral artery lesions are the important predictors of PMD.关键词
脑梗死/危险因素/幕上皮质下梗死/进展性运动功能缺损Key words
Brain infarction/ Risk factor/ Supratentorial subcortical infarcts/ Progressive motor defect
