基底动脉高密度征与急性后循环脑梗死患者短期预后的相关性

目的探讨在非增强头部CT上显示的基底动脉高密度征(HDBA)与急性后循环脑梗死患者短期预后的相关性。方法回顾性分析发病48h内行非增强头部CT检查的后循环脑梗死患者103例。根据发病14 d时美国国立卫生院卒中量表评分(NIHSS),将患者分为短期预后不良组(30例)和短期预后较好组(73例)。分析HDBA与患者短期预后的关系。其中75例在发病7 d内行头部CT血管造影(CTA)或MR血管造影(MRA)检查,分析血管病变程度与HDBA的关系。结果①预后不良组HDBA、糖尿病患者所占比率及入院时NIHSS评分高于短期预后较好组,差异均有统计学意义,P<0.01。②Binary Logistic回归分析显示,HDBA(OR=0.053,95%CI:0.013～0.213,P<0.01)和入院时NIHSS评分(OR=0.705,95%CI:0.521～0.955,P<0.05)是影响急性后循环脑梗死患者短期预后不良的独立危险因素。③75例行血管检查的患者中,28例为HDBA组,47例为非HDBA组。HDBA组和非HDBA组重度狭窄或闭塞患者所占比率分别为71.4%(20/28)和6.4%(3/47),差异有统计学意义,P<0.01。结论 HDBA可能是影响急性后循环脑梗死短期预后的参考指标。

Hyperdense basilar artery sign and short-term prognosis of acute posterior circulation ischemic stroke: a correlative study

Objective To investigate the correlation between the hyperdense basilar artery （HDBA） sign on non-enhanced head CT and the short-term prognosis of acute posterior circulation isehemic stroke. Methods A total of 103 patients with posterior circulation ischemic stroke performed non-enhanced head CT within 48 hours of onset were analyzed retrospectively. The patients were divided into either a short-term poor prognosis group （n = 30） or a short-term good prognosis group （n = 73） according to the National In-stitutes of Health Stroke Scale （NIHSS） at day 14 after onset. The relationship between HDBA and short-term prognosis of the patients was analyzed. 75 patients performed head CT angiography or MR angiography （MRA） examination within day 7 after onset. The relationship between the degree of vascular lesion and HDBA was analyzed. Results ①The percentages of HDBA and diabetes as well as the NIHSS scores at admission in the short-term poor prognosis group were higher than those in the short-term good prognosis group. There were significant difference （P 〈 0.01 ）. ②Binary logistic regression analysis indicated that HDBA （OR=0.053; 95%C10.013 to0.213; P〈0.01） and the NIHSS scores （OR=0.705; 95%CI 0. 521 to 0. 955 ; P 〈 0.05 ） at admission were the independent risk factors affecting short-term poor progno-sis in patients with posterior circulation ischemic stroke. ③Of the 75 patients with vascular examination, 28 were in the HDBA group and 47 were in the non-HDBA group. The percentages of the patients with se-vere stenosis or occlusion in the HDBA group and non-HDBA group were 71.4% （20/28） and 6.4% （3/47） respectively. The difference was statistically significant （P 〈 0.01 ）. Conclusion HDBA was an in-dependent risk factor affecting the short-term prognosis of acute posterior circulation ischemic stroke.