摘要
目的探讨急性脑梗死(acute cerebral infarct,ACI)患者TOAST和MRI分型与其短期预后的相关性。方法选取2013年3月—2015年2月在我院治疗的ACI患者200例,比较TOAST和MRI不同分型患者入院时美国国立卫生研究院卒中量表(NIH stroke scale,NIHSS)评分及评分减少率,并分析两种分型与不同短期预后患者的关系。结果不同TOAST分型患者NIHSS评分及减少率比较差异均有统计学意义(P<0.05或P<0.01),其中心源性栓塞型患者入院时NIHSS评分最高,NIHSS评分减少率最低,小动脉闭塞型患者入院时NIHSS评分最低,NIHSS评分减少率最高。不同MRI分型患者NIHSS评分及减少率比较差异均有统计学意义(P<0.01),其中大梗死型患者入院时NIHSS评分最高,NIHSS评分减少率最低,腔隙梗死型患者入院时NIHSS评分最低,NIHSS评分减少率最高。多因素Logistic回归分析结果显示:未加入MRI分型前,TOAST分型为患者短期预后的影响因素(P<0.05),加入MRI分型后,TOAST分型与短期预后无相关(P>0.05),而MRI分型为患者短期预后的影响因素(P<0.01)。结论TOAST和MRI分型对ACI患者短期预后均有一定的预测价值,但MRI分型优于TOAST分型。
Objective To explore the correlation between TOAST and MRI classification and short-term prognosis of patients with acute cerebral infarction(ACI).Methods A total of 200 ACI patients treated in our hospital from March 2013 to February 2015 were selected.The NIHSS score and score reduction rate of patients with different TOAST and MRI classifications were compared when on admission,and the relationship between the two classifications and the different short-term prognosis of patients was analyzed.Results Differences in NIHSS scores and reduction rates between patients with different TOAST classifications were statistically significant(P<0.05 or P<0.01).The NIHSS score of patients with cardiogenic embolism was the highest on admission,and the reduction rate of NIHSS score was the lowest.The NIHSS score of patients with arteriolar occlusion was the lowest on admission,and the reduction rate of NIHSS score was the highest.The differences in NIHSS scores and reduction rates of patients with different MRI classifications were statistically significant(P<0.01).Among them,patients with large infarction had the highest NIHSS score and the lowest reduction rate of NIHSS score on admission.Patients with lacunar-type infarction had the lowest NIHSS score and the highest reduction rate of NIHSS score on admission.The results of multivariate logistic regression analysis showed that before MRI classification was added,TOAST classification was an influencing factor for the short-term prognosis of patients(P<0.05).After MRI classification was added,TOAST classification had no correlation with short-term prognosis(P>0.05).The MRI classification is an influencing factor for the short-term prognosis of patients(P<0.01).Conclusion TOAST and MRI classification have certain predictive value for the short-term prognosis of ACI patients,but MRI classification is superior to TOAST classification.
作者
马书静
陈晓春
龚珊珊
张继超
MA Shu-jing;CHEN Xiao-chun;GONG Shan-shan;ZHANG Ji-chao(Department of Neurology,the First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China)
出处
《临床误诊误治》
2020年第12期99-102,共4页
Clinical Misdiagnosis & Mistherapy
基金
河北省卫生和计划生育委员会科研基金项目(20151379)。
