应用弥散张量成像技术预测脑干梗死运动功能康复结局的研究

目的 应用弥散张量成像技术预测脑干梗死运动功能康复结局.方法 选择79例急性脑干梗死残疾患者[改良RANKIN量表(mRS)评分≥3分],将性别、年龄(>65岁)、原发性高血压、糖尿病、高脂血症、心房颤动、吸烟史、初始残疾程度、锥体束受累程度作为观察指标,随访90 d,将患者的肢体功能康复结局分为残疾组和无残疾组,分析影响肢体功能功能康复结局的预测因素.结果 统计结果 显示糖尿病(χ2=8.447,P=0.004)、初始残疾程度(Hc=31.393,P=0.000)、锥体束受累程度(Hc=35.504,P=0.000)同患者残疾康复结局有关.采用非条件Logistic回归分析发现,糖尿病(OR=1.742,P=0.031)、锥体束受累程度(OR=4.385,P=0.012)是患者肢体运动功能康复结局的危险影响因素.结论 借助弥散张量成像技术显示的锥体束受累程度为脑干梗死肢体功能康复结局的最有价值的预测因素.

Diffusion tensor imaging technology is applied to predict the motor function rehabilitation outcome of brainstem infarctions

Objective To predict the motor function rehabilitation outcome of brainstem infarctions by using the diffusion tensor imaging technology.Methods Seventy-nine cases of acute brainstem infarctions with disability (mRS score≥3 points) were followed up for 90 days.Observational indexs include gender,age(>65 ages),hypertension,diabetes hyperlipidemia,atrial fibrillation,smoking history,the initial degree of disability,and degree of pyramidal tract involvement.Patients were assigned into disability group and non-disability group to analyze predictive factors influencing the function rehabilitation outcome.Results Using chi-square test to make univariate analysis,we found that diabetes (χ2=8.447,P=0.004),the initial degree of disability (Hc=31.393,P=0.000),and degree of pyramidal tract involvement (Hc=35.504,P=0.000) were associated with rehabilitation outcome of disabled patients.Using binary classification unconditioned Logistic regression analysis,we found that diabetes (OR=1.742,P=0.031) and degree of pyramidal tract involvement (OR=4.385,P=0.012) were the risk factor of extremity motor function rehabilitation outcome.Conclusions The pyramidal tract involvement reflected by diffusion tensor imaging is the best predictor factor for limb function rehabilitation outcome for brainstem infarctions.