大脑中动脉供血区大面积脑梗死患者出现致死性脑水肿的早期预测因素

目的 分析大脑中动脉供血区大面积脑梗死患者出现致死性脑水肿的早期预测因素.方法 回顾性研究大脑中动脉供血区大面积脑梗死患者发病24 h内的临床、实验室、影像学因素 病例组为死于致死性脑水肿的患者,对照组为其余存活者.结果 共有72例患者入院,病例组26例,对照组46例 多变量logistic回归分析显示,2组的发病24 h内NIHSS评分（P=0.017）和脑梗死类型（P=0.001）2个因素有显著差异.结论 发病24 h内NIHSS评分≥24、脑梗死范围＞大脑中动脉供血区可能是大脑中动脉供血区大面积脑梗死患者出现致死性脑水肿的早期独立预测因素.

A study on the early predictors of fatal brain edema in large infarcts supplied by middle cerebral artery

Objective To investigate the early predictors of fatal Brain edema of middle large infarction cerebral artery (MCA). Methods This study was a retrospective case-control study of patients who were with large MCA infarction and were admitted within 24 hours after symptom onset. Case group were defined as patients who died of fatal brain edema and control group were defined as patients who remained living. We analyzed the clinical, laboratory and radiographic features within 24 hours after symptom onset. Results There were 26 patients in the case group and 46 patients in the control group. Multivariate logistic regression of clinical, laboratory and radiographic features revealed NIHSS score over 24 within 24 hours after symptom onset(P=0.017) and infarct area over MCA territory involvement (P=0.001) as independent predictors of fatal brain edema. Conclusions Patients with large MCA infarction are at high risk for developing fatal brain edema when their NIHSS score exceeded 24 within 24 hours after symptom onset or cerebral infarction territory exceeded MCA territory.