后循环缺血性事件患者预后的临床分析

目的 评估206例后循环缺血性事件患者30d预后,探讨不同病变部位及受累血管与30d预后不良的相关性.方法 收集206例后循环急性脑梗死和短暂性脑缺血发作患者的临床资料.全部患者均在入院时进行美国国立卫生院神经功能缺损量表(NIHSS)、改良Rankin残障量表(MRS)评估,病后30d进行MRS评估,分析患者30d预后;系统评价病变部位及受累血管,并与预后不良进行相关性分析.结果 本组206例,病后30d病死率为4.9%,致残率为18%,颅脑近中远段同时受累(r=9.270,P＜0.001)、基底动脉急性闭塞(r=5.106,P＜0.001)及颅内病变个数＞1个(r=2.491,P＜0.001)的患者预后不良.结论 不同病变部位、血管引起的后循环缺血性事件预后不同,大部分预后良好.

The analysis of the 30 days progression of patients with posterior circulation ischemic cerebrovascular disease

Objective To evaluate the outcome at 30 days of patients with posterior circulation ischemic event and discuss the correlation at different stroke location and vascular lesions with poor outcome at 30 days.Methods 206 patients with posterior circulation ischemic stroke or TIA,who were admitted in 2003 were evaluated using NIHSS and MRS on admission,and were revaluated again at 30 days using MRS.The location and vessel of lesions were evaluated systematically and the multivariate logistic regression analysis of the progress at 30 days and the correlated factor analysis were performed.Results We found a low mortality rate(4.9%)and relatively low rates of major disability(18%)at 30 days after onset.Patients with proximal,middle and distal territory involvement(r=9.270,P<0.001),multiple posterior circulation,intracranial territory involvement(r=2.491,P<0.001),in basilar artery acute occlusion(r=5.106,P<0.001)are more likely to have poor outcome.Conclusions We discover that vertebrobasilar occlusive disease is consists of a variety of different stroke locations and vascular lesions,but the majority have good prognosis.