大脑中动脉高密度征与大面积脑梗死预后的相关性研究

目的探讨大脑中动脉高密度征(HMCAS)与大面积脑梗死预后的关系。方法回顾性分析我院139例大面积脑梗死患者的影像学及临床资料。结果根据OCSP分型:98例(98/139)完全前循环梗死(TACI),41例(41/139)部分前循环梗死(PACI)。据首次CT检查中是否出现HMCAS分两组,HMCAS组58例(58/139);非HMCAS组81例(81/139);所有患者因不符合溶栓指征未行溶栓治疗,其中34例(34/139)患者发生梗死后出血。HMCAS组伴出血者21例(21/58),死亡者11例(11/58),非HMCAS组伴出血者13例(13/81),死亡者5例(5/81)。HMCAS组的出血率、死亡率明显高于非HMCAS组。差异具有统计学意义(χ2出血率=7.43,χ2死亡率=5.43,P0.05)。大面积脑梗死患者出现HMCAS,其伴梗死后出血的发生率和死亡率均高于无HMCAS患者。结论 HMCAS出现可以作为脑梗死预测梗死后出血的指标之一,并可提示大面积脑梗死预后不佳。

The correlation study between the hyperdense middle cerebral artery sign and Large area cerebral infarction prog-nosis

Objective To explore the correlation between the hyperdense middle cerebral artery sign and prognosis of large area cerebral infarction .Methods One hundred and thirty-nine patients were diagnosed as large area cerebral in-farction in our hospital ,and the clincal and imaging data were retrospectively analyzed .Results According to the OCSP ( Oxfordshire Community Stroke Project ) classification ,ninety-eight cases were classified to total anterior circulation infarcts (TACI),and 41 cases were partial anterior circulation infarcts (PACI).We divided those cases into two groups according to the first CT examination whether the HMCAS appeared in two groups:58 cases of HMCAS group ,81 cases of no-HMCAS group.All of them did not fit with the thrombolysis indications ,and did not treated with thrombolytic therapy ,including 34 cases with hemorrhagic transformation .In HMCAS group ( 58 ) , twenty-one cases with hemorrhagic transformation were found,and 11 cases of HMCAS group were dead .In no-HMCAS group,hemorrhagic transformation were 13 cases,and 5 ca-ses were in death .The hemorrhage rates and mortality rates of HMCAS group were higher than that of no-HMCAS group . There was statistical significance between them (P<0.05).HMCAS appeared in large area cerebral infarction ,the hemor-rhagic transformation and mortality rates were higher than the patients without HMCAS .Conclusion HMCAS in cerebral infarction can be one prediction index of hemorrhagic transformation ,and prompt the poor prognosis .