脑卒中后中枢性面瘫闭目乏力与脑卒中预后的关系

目的探讨脑卒中后中枢性面瘫闭目乏力与脑卒中预后的关系。方法观察1年内所有起病7d内的脑卒中患者,入院当天使用拉力测量器测量双眼闭目力量,按测量结果分为中枢性面瘫伴闭目乏力和不伴闭目乏力两组,比较两组入院当天、发病第7、14、21、30天的美国国立卫生院脑卒中量表评分(National Institute of Health stroke scale,NIHSS)以及发病第30、90、180天的Barthel指数(Barthel index,BI)、修正Rankin量表评分(modified Rankin Scale,mRS)。结果入院当天2组的NIHSS无统计学差异,而伴闭目乏力者在脑卒中发病第21和30天的NIHSS较不伴闭目乏力者高(P<0.05)。在脑卒中发病第30、90、180天,伴闭目乏力者的BI≥85的比例比不伴闭目乏力者低;在脑卒中发病第90、180天,伴闭目乏力者的mRS≤2的比例比不伴闭目乏力者低。结论脑卒中后中枢性面瘫伴闭目乏力提示较差的预后。

Eye closure weakness in stroke patients with cerebral hemispherical lesions is an indicator of a poor prognosis following stroke.

Objective To investigate the relationship between weakness of eye closure induced by cerebral hemispherical lesion (WECICHL) and prognosis following stroke. Methods All patients were recruited into the study during 1-year period. The strength to close eyelid was measured using an ergometer. The differences of strength to close eyelid between the two sides>0.02 kgf was considered as significant. Neurological outcome,neurological disability and handicap were assessed using National Institutes of Health stroke scale (NIHSS),Barthel index (BI) and modified Rankin Scale (mRS),respectively. The evaluation of all indexes was started within the first week of the onset of stroke. NIHSS was measured repeatedly on 7,14,21,30 days following stroke. BI and mRS were measured repeatedly 30,90 and 180 days following stroke. Results Non-WECICHL patients had lower NIHSS than WECICHL patients at Day 21 and 30 (P<0.05). The number of patients with good outcomes (BI of at least 85 and mRS score 0~2) was greater in the Non-WECICHL group than in the WECICHL group. Conclusions WECICHL indicates a poor prognosis following stroke.