脑白质疏松对脑梗死预后的影响

目的:探讨脑白质疏松(LA)对脑梗死预后的影响。方法:将在发病48h内住院的173例急性脑梗死患者按照是否伴有LA分为伴LA组(63例)与单纯脑梗死组(110例),并随访1a,分别于入院时,治疗后1、6、9个月及1a时行中国脑卒中临床神经功能缺损程度(CSS)、日常生活能力评定Barthel指数(BI)、简易精神状态量表(MMSE)测评,并统计脑梗死复发率。结果:2组患者随访期内CSS评分、BI、MMSE评分组内效应、组间效应及交互效应差异均有统计学意义。2组入院时及治疗后1个月、3个月时CSS、BI及MMSE评分差异无统计学意义(P>0.05)。治疗后6个月以后脑梗死伴LA组CSS评分高于单纯脑梗死组,BI及MMSE评分低于单纯脑梗死组(P<0.05)。随访1a,脑梗死伴LA组脑梗死复发时间(10.651±0.037)个月(95%CI为9.926～11.376个月),单纯脑梗死组为(11.464±0.173)个月(95%CI为11.125～11.802个月),脑梗死伴LA组脑梗死复发时间早于单纯脑梗死组(χ2L=4.964,P=0.026)。结论:LA对脑梗死的预后有明显影响,且增加复发风险。

Effect of leukoaraiosis on prognosis of cerebral infarction

Aim:To study the effect of leukoaraiosis(LA) on prognosis of cerebral infarction.Methods:A total of 173 patients with acute cerebral infarction within 48 h were divided into co-LA group(63 cases) and non-LA group(110 cases).The Chinese Stroke Scale(CSS) score,Barthel Index(BI) of daily living assessment,the mini-mental state examination(MMSE) score and the recurrence were recorded at admission,1,3,6,9 months and 1 a after admission.Results:There were significant differences in CSS,BI and MMSE score between the two groups at different time points(P<0.05).There was no significant difference between the two groups in CSS,BI and MMSE score at admission and 3,6 months after the admission(P>0.05).At 6,9 months and 1 a after the admission,co-LA group had higher CSS score,lower BI and MMSE score compared with non-LA group(P<0.05).During one-year follow-up,the time of recurrence of cerebral infarction in co-LA group was(10.651±0.037) months(95%CI was 9.926～11.376 months),significantly higher than that(11.464±0.173) months(95% CI was 11.125～11.802 months) in non-LA group(χ2L=4.964,P=0.026).Conclusion:LA may increases the recurrence risk of cerebral infarction.