急性脑梗死患者临床分型特点与预后研究

目的了解急性脑梗死（ACI）患者牛津郡社区卒中计划（OCSP）分型的构成特点及其与预后的相关性。方法对208例ACI患者进行美国国立卫生研究所卒中量表（NIHSS）评分,并按照OCSP标准分为4大亚型,分析不同亚型与NIHSS评分的关系。结果本组OCSP各亚型构成比：完全前循环型13.46%、部分前循环型30.29%、后循环型19.71%、腔隙性梗死型36.54%;OCSP四个亚型中,完全前循环型NIHSS评分最高、预后最差;其次为后循环型和部分前循环型,腔隙性梗死型NIHSS评分最低。与腔隙性梗死型比较,完全前循环型和后循环亚型NIHSS评分差异有统计学意义（P〈0.01）。结论 ACI患者NIHSS评分随OCSP不同亚型而变化,OCSP分型可作为ACI患者预后评估的指标之一。

Study on Feature and Prognosis in Patients with Different Subtypes of Acute Cerebral Infarct

Objective To study the composition feature of different classifications in acute cerebral infarction based on the Oxfordshire Community Stroke Project（OCSP） and the relationship with prognosis in acute infarction patients.Methods 164 ACI patients were classified into 4 groups based on the criteria of OCSP.All patients were scored according to the American National Institutes of Health Stroke Scale（NIHSS） to explore the relationship between the score and different subtypes.Results The percentage of each ischemic stroke OCSP subtype were as follows：total anterior circulation infarcts was 13.46%,partial anterior circulation infarcts was 30.29%,posterior circulation infarcts was 19.71%,and lacunar infarcts was 36.54%.Among 4 major stroke subtypes,total anterior circulation infarcts patients had the highest NIHSS score.Lacunar infarcts subtypes were associated with the lowest levels of NIHSS score.Compared with lacunar infarcts subtypes,NIHSS score increased significantly in total anterior circulation infarcts and posterior circulation infarcts patients（P0.05）.Conclusion Levels of NIHSS score varied in different subtypes of ACI.OCSP classification should be useful to prognosis of ischemic stroke as an clinical classification.