MRI结合神经功能学评定预警进展性腔隙性脑梗死的临床研究

目的:评估MRI等神经影像学和神经功能学评定在预警急性腔隙性脑梗死进行性恶化发展中的作用.方法:回顾性调查发病48 h内入院的61例幕上腔隙性脑梗死患者.进展性脑梗死(progressive-type stroke,PS)定义为用美国国立卫生院卒中量表(NIHSS)评分法确定的发病7 d内,运动功能进行性加重的腔隙性脑梗死.结果:16例(26%)患者为PS组.与非PS组相比,PS组波动性或进展性方式发病的比例分别为81%,42%(P=0.009),以下肢为主的运动功能障碍发生率分别为63%,16%(P=0.001),弥散加权MRI显示的放射冠区梗死灶检出率分别为100%,69%(P=0.013),均有显著地增高.结论:MRI结合神经功能评定不仅能很好预示急性腔隙性脑梗死可能进行性发展加重,而且可以帮助临床医生更好地防治进展性腔隙性脑梗死的发生和发展.

Clincal research of Neurological and MRI in predicting progressive lacunar infarction

Objective: To find the role of MRI neural imaging and neurological to predict acute lacunar infarctions. Meth-ods: Retrospective investigation of 61 patients with supratentorial lacunar infarct, who were admitted within 48 hours. Pro-gressive-type stroke (PS)was defined as progressive motor deficits that arose within 7 days after onset, by using the motor ratings of the National Institutes of Health Stroke Scale. Results: 16 patients(26%)were classified into the PS group. Com-pare with the non-PS group, fluctuating or progressing onset were 81% and 42%(P=0.009), leg-predominant motor deficits on admission were 63% and 16% (P= 0.001) and corona radiata lesion on diffusion-weighted MRI were 100% and 69%(P= 0.013), PS were more frequent than the non-PS group. Conclusion: Neurological assessment and MRI can help us to pre-dict PS and start early intensive treatment for preventing further neurological deterioration.