椎基底动脉系统脑梗死患者六个月预后研究

目的评估椎基底动脉系统脑梗死患者6个月的预后,探讨不同病变部位及受累血管与预后不良的相关性。方法收集2003年我院收治的168例椎基底动脉系统脑梗死患者的资料,随访病后6个月的情况,评价病变部位及受累血管,进行病后6个月预后不良的相关因素分析。结果患者病后6个月预后不良发生率为19．6％,其中病死率11．9％,严重残障率7．7％。颅脑近中远段同时受累（RR=5．392,95％CI 1．229～23．657,P〈0．05）,颅内病变个数〉1个（RR=3．077,95％C10．993～9．537,P〈0．05）,基底动脉急性闭塞（RR=11．766,95％CI3．455-40．074,P〈0．001）,颅外段椎动脉病变（RR=4．376,95％CI 1．081～17．714,P〈0．05）的患者预后不良。结论不同病变部位及受累血管的椎基底动脉系统脑梗死患者预后不同,大部分预后良好。

The 6-month outcome in patients with vertebrobasilar system cerebral infarction

OBJECTIVE: To evaluate the 6-month outcome in patients with vertebrobasilar system cerebral infarction and discuss the correlation of different stroke localization and vascular lesions with poor outcome. METHODS: 168 patients with vertebrobasilar system cerebral infarction, who were admitted in 2003 were evaluated for neurologic impairment and functional handicap. The stroke localization and vascular lesions were evaluated systematically and multivariate logistic regression analysis of the 6-month outcome and correlative factors was performed. RESULTS: It was found that the incidence of poor 6-month outcome was 19.6%. The mortality rate was 11.9% and major disability 7.7%. Patients with proximal, middle and distal territory involvement (RR=5.392, 95% CI 1.229-23.657, P<0.05), multiple vertebrobasilar intracranial territory involvement (RR=3.077, 95% CI 0.993-9.537, P<0.05), acute occlusion of basilar artery (RR=11.766, 95% CI 3.455-40.074, P<0.001), extracranial vertebral artery lesion (RR=4.376, 95% CI 1.081-17.714, P<0.05) were more likely to have poor outcome. CONCLUSIONS: It is shown that vertebrobasilar occlusive disease may consist of a variety of different stroke localizations and vascular lesions, many with of the patients have good prognosis.