急性缺血性脑卒中OCSP分型与神经影像学结果和心电图及常见血液生化指标的关系

目的探讨急性缺血性脑卒中OCSP分型与神经影像学结果、心电图以及常见血液生化指标的关系。方法符合入选标准的156例急性缺血性卒中患者入院后进行Oxfordshire Communit Stroke Project(OCSP)临床分型为完全前循环梗死组(TACI组),部分前循环梗死组(PACI组),后循环梗死组(POCI组)和腔隙性梗死组(LACI组),并做各种常规及血液生化、心电图及颅脑CT或MRI检查。再根据影像学上病灶的大小进行分类。结果(1)按照OCSP分型方法,TACI组14例(8.98%),PACI组89例(57.05%),POCI组32例(20.51%),LACI组21例(13.46%);(2)OCSP临床分型与影像学诊断具有良好的一致性(Kappa=0.624,P<0.01);(3)TACI组与PACI组心电图的异常率相比差异无统计学意义(P<0.05),TACI组与POCI组心电图异常率比较差异有统计学意义,TACI组和LACI组差异亦有统计学意义(P<0.05);(4)TACI组和POCI组血糖比较差异无统计学意义(P>0.05),而此两组的血糖分别与PACI组和LACI组比较差异有统计学意义(P<0.05)。结论OCSP分型是一种对急性缺血性卒中进行简单、快速分类的方法,能准确地预测出脑成像上的梗死灶位置和体积。

Relation of the OCSP Classification with the Results of Neuro-imaging,Electrocardiography and Blood Biochemical Indexes in Acute Ischemic Stroke

Objective To investigate the relation of the types of Oxfordshire Community Stroke Project (OCSP) with the neuro-imaging,electrocardiogram and the common blood biochemical indicator in acute ischemic stroke.Methods The OCSP types,total anterior circulation infarction(TACI),partial anterior circulation infarction(PACI),lacunar infarction (LACI),posterior circulation infarction(POCI) were clinically achieved in 156 acute ischemic stroke patients,and various routine check,blood biochemical assay,electrocardiogram,ultrasonography,and craniocerebral CT or MRI were performed.Then the classification was done according to the sizes and sites of foci in brain imaging.Results Among the 156 ischemic stroke patients admitted,14 (8.98%) were classified as TACI,89(57.05%) as PACI,32 (20.51%)as POCI,and 21(13.46%)as LACI.The satisfactory consistency was showed between OCSP classification and brain imaging diagnosis (Kappa=0.624,P<0.01).In abnormity ratio of electrocardiogram there was a significant difference between TACI and PACI subtypes,and so was between TACI and LACI (P<0.05),Serum glucose levels of TACI and POCI subtypes showed no significant differenced,however,they were obviously higher than those of PACI and LACI subtypes,with a significant difference (p<0.05).Conclusion The OCSP classification is a simple,rapid,and reliable method of categorizing acute ischemic stroke patients.It may reliably predict site and size of infarct on brain imaging.