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目的研究脑梗死急性期OCSP分型与神经功能缺损和预后的关系。方法连续收集首次发病的急性脑梗死(发病时间在10d以内)患者160例,按OCSP分型分为完全前循环梗死(TACI)、部分前循环梗死(PACI)、腔隙性脑梗死(LACI)、后循环梗死(POCI),比较斯堪的纳维亚神经功能缺损评分,入组后30d、6个月的患者病死率、脑卒中复发率(包括缺血性和出血性)和日常生活能力。结果急性期神经功能缺损以TACI最重,POCI、PACI次之,LACI最轻,入组后30d的患者病死率为TACI>POCI>PACI>LACI,6个月时病死率仍然是TACI>POCI>PACI>LACI,而6个月内脑卒中复发率是PACI>POCI>LACI>TACI,存活6个月者残疾程度TACI最重(重度依赖),其余3个亚型均为轻度依赖。结论脑梗死急性期不同OCSP分型之间的脑梗死患者急性期神经功能缺损、30d及6月时预后存在差异,不同的OCSP分型可以反映脑梗死急性期神经功能缺损的严重程度和预后,OCSP分型有利于脑梗死急性期治疗和康复方法的选择。
Objective To study the relationship between OCSP classification and neurological deficit and prognosis in acute cerebral infarction. Methods Totally 160 patients with first onset acute cerebral infarction (onset time less than 10 days) were divided into three groups according to OCSP classification: complete anterior circulation infarction (TACI), partial anterior circulation infarction (PACI), lacunar infarction (LACI) , Posterior circulation infarction (POCI), Scandinavian neurological deficit score, patient mortality at 30 days and 6 months after admission, relapse rate of stroke (including ischemic and hemorrhagic) and daily living ability . Results The TACI, POCI, PACI and LACI were the lowest in the acute stage. The mortality rate was TACI> POCI> PACI> LACI at the 30th day after operation. The mortality rate at 6 months was still TACI> POCI> PACI> LACI. The recurrent rate of stroke within 6 months was PACI> POCI> LACI> TACI, and the degree of disability TACI was the heaviest (severe dependence) after six months of survival. The other three subtypes were mildly dependent. Conclusions The acute phase of cerebral infarction patients with acute cerebral infarction have different neurological deficits in 30 acute cerebral infarction patients and different cerebral infarction patients in June. The different OCSP patterns can reflect the severity and prognosis of acute cerebral infarction patients with neurological deficits, OCSP classification is conducive to the treatment of acute cerebral infarction and rehabilitation methods of choice.