快速和缓慢进展型脑干梗死的影响因素OACSTPCD

Objective To investigate the influencing factors for slowly progressive brainstem infarction and rapidly progressive brainstem infarction in patients with severe stenosis or occlusion of basilar artery.Methods A retrospective analysis was performed for 501 patients who attended Zhengzhou University People's Hospital from January 2013 to Decem-ber 2022 and were diagnosed with first-episode brainstem infarction after severe stenosis or occlusion of basilar artery by HR-MRI.The core volume of brainstem infarction was manually calculated,and the distribution of brainstem infarct vol-ume was analyzed.According to brainstem infarct volume and the time from stroke attack to imaging,the patients were di-vided into slowly progressive brainstem infarction group(0-<1 ml,6-24 hours)and rapidly progressive brainstem infarc-tion group(>5 ml,0-<6 hours),and the two groups were compared in terms of risk factors and collateral circula-tion.Results The 501 patients with severe stenosis or occlusion of basilar artery had a mean age of 66.14±10.37 years,among whom 39.13%were male patients.According to predefined thresholds,29 patients(16.29%)with severe stenosis or occlusion of basilar artery in the time window of 0-<6 hours were diagnosed with rapidly progressive brainstem infarc-tion,and 56 patients(17.34%)in the time window of 6-24 hours were diagnosed with slowly progressive brainstem infarc-tion.There were no significant differences between the two groups in the risk factors such as age,sex,NIHSS score,hy-pertension,diabetes,hyperlipidemia,and history of atrial fibrillation,coronary artery disease,and smoking.The Pear-son correlation analysis showed that collateral circulation in patients with severe stenosis or occlusion of the basilar artery was negatively correlated with rapidly progressive brainstem infarction(r=-0.619,P<0.001).Conclusions After se-vere stenosis or occlusion of the basilar artery,patients with good collateral circulation often have slowly progressive brain-stem infarction,while patients with poor collateral circulation often have rapidly progressive brainstem infarction.