基底动脉狭窄程度与孤立性脑桥梗死短期转归的相关性

目的探讨基底动脉狭窄程度与急性孤立性脑桥梗死短期转归的相关关系.方法连续纳入2016年4月至2018年4月在开封市中心医院神经内科入住的急性孤立性脑桥梗死患者共137例.根据1月改良Rankin量表(mRS)评分将患者分为转归良好组(mRS≤2分)和转归不良组(mRS评分>2分),入院当天或第2天采集空腹静脉血进行血液生化指标检查,详细记录美国国立卫生研究院卒中量表(NIHSS)评分及其他人口统计学资料进行比较.应用磁共振血管成像评估患者的基底动脉狭窄程度,并根据血管狭窄程度分为无狭窄、轻度狭窄、中度狭窄和重度狭窄.结果转归良好组108例,转归不良组29例.转归良好组基线NIHSS评分(2.71±0.22)分比(7.10±0.59)分,t=6.99,P<0.01]和总胆固醇水平(4.29±0.10)mmol/L比(4.76±0.17)mmol/L,t=2.21,P=0.03]低于转归不良组.转归良好组中基底动脉无狭窄的患者发病比例高于转归不良组76(70.4%)比5(17.2%),χ²=26.70,P<0.01],而基底动脉重度狭窄患者比例低于转归不良组4(3.7%)比7(24.1%),P=0.002].二变量Logistics回归分析结果表明,NIHSS评分及基底动脉血管的狭窄程度是患者短期转归的危险因素(OR=1.658,95%CI:1.327~2.071;P=0.000和OR=2.071,95%CI:1.159~3.701;P=0.014).结论基底动脉血管狭窄程度是急性脑桥梗死患者短期转归的危险因素,基底动脉狭窄愈严重,脑桥梗死患者的预后愈差.

The relationship between the degree of basilar artery stenosis and the short-term prognosis in patients with isolated pontine infarction

Objective To investigate the relationship between the degree of basilar artery stenosis and the short-term prognosis in patients with isolated pontine infarction.Methods One hundred and thirty-seven patients with isolated pontine infarction within 1 month after symptom onset admitted to our hospital from April 2016 to April 2018 were consecutively included.Based on modified Rankin scale(mRS)socres,patients were divided into the good outcome group(mRS score≤2)and the poor outcome group(mRS score>2).Venous blood samples were taken for biochemical testing on admission or the next day.Baseline National Institutes of Health Stroke Scale(NIHSS)scores and demographic data were recorded and compared between the two groups.The degree of basilar artery stenosis was assessed by magnetic resonance angiography(MRA),and subjects were divided into the non-stenosis,mild stenosis,middle stenosis and severe stenosis subgroups.Results There were 108 patients in the good outcome group and 29 in the poor outcome group.The baseline NIHSS score(2.71±0.22 vs.7.10±0.59,t=6.99,P<0.01)and total cholesterol(4.29±0.101)mmol/Lvs.(4.76±0.17)mmol/L,t=2.21,P=0.03]were lower in the good outcome group than in the poor outcome group.The proportion of patients without stenosis was higher(76 or 70.4%vs.5 or 17.2%,χ²=26.70,P<0.01)and the proportion of patients with severe stenosis were lower(4 or 3.7%vs.7 or 24.1%,P=0.002)in the good outcome group than in the poor outcome group.Binary logistics regression analysis showed that baseline NIHSS score(OR=1.658,95%CI:1.327-2.071,P=0.000)and degree of basilar artery stenosis(OR=2.071,95%CI:1.159-3.701,P=0.014)were risk factors for the short-term prognosis.Conclusions The degree of basilar artery stenosis is a risk factor for the short-term prognosis in patients with isolated pontine infarction,and patients with severer stenosis will have a poorer prognosis.