脑侧支循环建立对脑梗死患者近期预后意义.docVIP

脑侧支循环建立对脑梗死患者近期预后意义 　　【摘要】目的探讨脑侧支循环建立对急性脑梗死患者近期预后的意义。方法前瞻性连续纳入神经内科2009年6月至2009年11月期间住院的急性脑梗死患者193例，根据颅内血管检查（MRA和/或CTA和/或DSA和/或TCD）有无侧支循环建立将患者分为侧支循环组（n=70）和对照组（n=123），在入院当天、发病第28天用MESSS 量表进行评定，并在发病第28天、第（90±1）天用巴氏指数评定表进行评定，用单因素和多因素Logistic回归模型对其行相关分析。结果入院第1天MESSS评分两组间差异无统计学意义（P0.05），发病第28天MESSS评分侧支循环组神经功能缺损程度轻于对照组（P0.05）。Logistic回归分析结果显示：以侧支循环开放作为因变量，发病第28天BI评分进入回归方程，OR值是1.391，95%可信区间（1.045，1.851），P=0.024。结论急性缺血性脑梗死有侧支循环建立的患者28天时预后好于无侧支循环建立患者，评估侧支循环建立对判断患者近期预后具有重要意义。 　　【关键词】经颅多普勒；脑梗死；侧支循环；预后；Logistic回归分析 　　中图分类号：R743.3文献标识码：ADOI：10.3969/j.issn2015.04.012 　　【Abstract】ObjectiveTo investigate significance of establishment of cerebral collateral circulation on the early prognosis of acute cerebral infarction patients.MethodsA prospective study was performed in 193 cases of acute cerebral infarction，who were consecutively admitted to department of neurology from June to November，2009.All patients were divided into collateral circulation group （n=70） and control group （n=123） according to whether cerebral collateral circulation was established by intracranial vascular examination （TCD and/or DSA and/or CTA and/or MRA） or not.MESSS was used to evaluate on the day of admission and the 28th day of illness.Barthel Index（BI） was used to evaluate on the 28th day and the （90±1）th day of the illness，then single factor and multiple factors Logistic regression model were used to conduct correlation analysis.Results Difference of MESSS on the first day of admission between the two groups was not statistically significant（P005）.MESSS of the 28th day of the illness showed that degree of neurological impairment of the collateral circulation group was less severe than that of the control group（P0.05）.The results of Logistic regression analysis showed that when the opening of collateral circulation was regarded as dependent variable and BI score of the 28th day of illness came into the regression formula，OR value was1.391，with 95% confidence intervals（1.045，1.851） and P=0.0