论文部分内容阅读
目的:探讨起病1周内全脑血管造影(DSA)未见血管阻塞的急性脑梗死患者的临床预后。方法:急性脑梗死患者260例,在发病1周内完成全脑血管DSA和头颅CT、MRI检查,采用NI HSS量表评估入院时病情,改良Rankin量表(mRS)评估患者3个月时的预后,mRS≤2分视为预后良好,并对影响患者预后的危险因素进行多因素logistic回归分析。结果:260例患者中,发病1周内全脑血管DSA正常者96例(37%),其中头颅MRI显示有相应梗死灶93例(97%),发病1周内脑血管自然再通率为18%(46/260)。脑血管DSA未见血管阻塞的患者3个月时预后良好者67例(70%)。多因素logistic回归分析显示,入院时NI HSS评分[OR=0.231(0.080～0.811),P=0.013]、是否为大面积脑梗死[OR=0.171(0.062～0.725),P=0.006]显著影响患者3个月时的预后。结论:起病1周内急性脑梗死患者血管的再通率为18%,DSA检查显示无血管阻塞的患者为37%,其中70%的患者预后良好,入院时的病情及脑梗死面积是影响患者3个月预后的主要因素。
Objective: To investigate the clinical outcomes of patients with acute cerebral infarction without vascular occlusion within 1 week after onset of cerebral angiography (DSA). Methods: Two hundred and sixty patients with acute cerebral infarction were enrolled in this study. Complete cerebrovascular DSA and CT scans were performed within 1 week of onset. The NIHSS was used to assess the patient’s condition at admission and the modified Rankin Scale (mRS) Prognosis, mRS ≤ 2 points as a good prognosis, and prognostic factors affecting the prognosis of patients by multivariate logistic regression analysis. Results: Of 260 patients, 96 cases (37%) had normal cerebrovascular DSA within 1 week of onset, of which 93 cases (97%) had corresponding infarction lesions by cranial MRI. The natural recanalization rate of cerebrovascular within 1 week 18% (46/260). Sixty-seven patients (70%) had a good prognosis at 3 months in patients with no vascular occlusion of cerebrovascular DSA. Multivariate logistic regression analysis showed that the NIHSS score at hospital admission [OR = 0.231 (0.080-0.811), P = 0.013] was significantly affected in patients with large area cerebral infarction [OR = 0.171 (0.062-0.725), P = 0.006] Prognosis at 3 months. CONCLUSIONS: The recanalization rate of blood vessels in patients with acute cerebral infarction within 1 week of onset was 18%. DSA showed 37% of patients without vascular obstruction. In 70% of patients, the prognosis was good, and the condition at admission and the infarct size affected Patients 3 months prognosis of the main factors.