目的 探讨脑小血管病(cerebral small vessel disease,CSVD)总负荷与急性脑梗死(acute cerebral infarction,ACI)患者早期预后的相关性.方法 选取 2020年 10 月至 2022 年 6 月嘉兴市第一医院神经内科收治的 150 例ACI患者,根据改良Rankin评分量表(modified Rankin scale,mRs)评分分为预后良好组(mRs≤2 分)和预后不良组(mRs≥3 分),对比两组患者的基线资料及临床特征,并通过头颅MRI评估CSVD总负荷.采用Logistic模型进行单因素及多因素分析,Pearson法分析CSVD总负荷与早期预后相关性.结果 单因素分析显示,预后不良组患者的年龄、住院天数、入院美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)、超敏C反应蛋白、三酰甘油、同型半胱氨酸均高于预后良好组,差异有统计学意义(P<0.05),预后不良组患者的腔隙、脑微出血、白质高信号及 CSVD 总负荷高于预后良好组,差异有统计学意义(P<0.05).多因素Logistic回归分析显示,住院天数(OR=1.278,95％CI=1.054～1.548,P=0.012)、入院NIHSS评分(OR=1.354,95％CI=1.113～1.647,P=0.002)、CSVD总负荷(OR=2.494,95％CI=1.666～3.735,P<0.001)是ACI患者早期预后不良的独立危险因素.结论 CSVD总负荷与ACI患者早期预后不良相关.
Correlation between total burden of cerebral small vessel disease and early prognosis in patients with acute cerebral infarction
Objective To investigate the correlation between the total load of cerebral small vessel disease(CSVD)and the early prognosis of patients with acute cerebral infarction(ACI).Methods A total of 150 patients with ACI admitted to the Department of Neurology,the First Hospital of Jiaxing from October 2020 to June 2022 were included,according to modified Rankin scale(mRs)score,patients were classified good prognosis group(mRs≤2 points)and poor prognosis group(mRs≥3 points),baseline data and clinical characteristics were compared between the 2 groups,and total CSVD load was assessed by cranial MRI,single factor and multi-factor analysis were performed with Logistic model.The relativity of CSVD load and early prognosis was analyzed with Pearson method.Results Age,length of stay,National Institute of Health stroke scale(NIHSS),hypersensitivity C-reactive protein,triglyceride and homocysteine were significantly higher in poor prognosis group than those in good prognosis group,the difference was significant(P<0.05).The scores of lacunar,cerebral microhemorrhage,white matter hyperintensity and CSVD in poor prognosis group were significantly higher than those in good prognosis group(P<0.05).Multivariate Logistic regression analysis showed that length of stay(OR=1.278,95％CI=1.054-1.548,P=0.012),admission NIHSS score(OR=1.354,95％CI=1.113-1.647,P=0.002),CSVD total load(OR=2.494,95％CI=1.666-3.735,P<0.001)were independent risk factors for poor early prognosis in patients with acute cerebral infarction.Conclusion CSVD load is associated with poor prognosis in patients with acute cerebral infarction.
万方数据
维普
