重庆医学2018，Vol.47Issue(6)：763-766,4.DOI:10.3969/j.issn.1671-8348.2018.06.013
梗死位置预测大脑中动脉区脑梗死进展性运动神经功能损伤
Infarction location for predicting cerebral infarction progressive motor nerve function deficits in middle cerebral artery area
摘要
Abstract
Objective To investigate the correlation between the infarction location and progressive motor deficits (PMD) occurrence.Methods The patients with middle cerebral artery(MCA) infarction within 24 h of onset without thrombolytic therapy were included.The National Institutes of Health Stroke Scale(NIHSS) motor item score increase ≥2 points of the base line within 7 d after stroke onset served as the PMD diagnostic criteria.The differences in clinical and laboratory data,and infarction location were compared between the PMD group and non-PMD group.The multivariate Logistic regression analysis predicted the risk factors of PMD occurrence.Results A total 121 patients with MCA acute cerebral infarction were included in the study and divided into the PMD group (45 cases) and non-PMD group (76 cases).The internal watershed infarction occurrencerate in the PMD group was higher than that in the non-PMD group (26.7 ％ vs.5.3％,p=0.001).The occurrence rate of penetrating arterial infarction (PAI) had no statistical difference between the PMD group and non-PMD group(42.2％ vs.35.5％,P=0.463).PAI was further divided into perforating branch atheromatous disease (BAD) and lipohyalinitic degeneration (LD).The occurrence rate of BAD in the PMD group was significantly higher than that in the non-PMD group (28.9％ vs.9.2％,P=0.005).The stepwise Logistic regression analysis indicated that watershed infarction [odds ratio (OR):9.750,95 ％ confidence interval(CI):2.828-33.612,P=0.000] and BAD lesion (OR:6.036,95 ％ CI:2.119-17.190,P =0.001) were the independent risk factors contributing to PMD.Conclusion Internal watershed infarction and BAD lesion may predict the PMD occurrence.The infarct location is conducive to find the high risk population of cerebral infarction progress.关键词
大脑中动脉区脑梗死/进展性运动神经功能损伤/内分水岭梗死/穿支动脉粥样硬化性疾病Key words
middle cerebral artery infarction/progressive motor deficits/internal watershed infarction/perforating branch atheromatous disease分类
医药卫生引用本文复制引用
朱筱琦,陆学胜,张允,许敏,严乾峰,丁冀..梗死位置预测大脑中动脉区脑梗死进展性运动神经功能损伤[J].重庆医学,2018,47(6):763-766,4.基金项目
上海市长宁区科学技术委员会项目(CNKW2015Y04). （CNKW2015Y04）
