1. 单发皮层下梗死患者早期神经功能恶化与豆纹动脉关系的研究 Relationship between Early Neurological Deterioration and Lenticulostriate Arteries Morphology in Patients with Single Subcortical Infarction
- Author
-
刘甜甜, 霍会永, 相世峰, 刘超, 张文超, 李军涛
- Subjects
单发皮层下梗死 ,早期神经功能恶化 ,豆纹动脉 ,磁共振血管壁成像 ,single subcortical infarction ,early neurological deterioration ,lenticulostriate artery ,magnetic resonance vessel-wall imaging ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
目的 利用全脑磁共振血管壁成像(magnetic resonance vessel wall imaging,MR VWI)研究单发皮层下梗死(single subcortical infarction,SSI)患者早期神经功能恶化(early neurological deterioration,END)与豆纹动脉(lenticulostriate artery,LSA)的关系。 方法 回顾性分析邯郸市中心医院神经内二科2020年10月—2022年1月连续住院的不伴有脑大动脉狭窄的SSI患者,根据有无发生END分为END组和非END组,通过全脑MR VWI影像学方法评估LSA可视化程度,基底节区无法看到LSA记为LSA可视化差,LSA覆盖不到一半的基底节区域记为LSA部分可视化,LSA覆盖基底节区域一半以上的区域记为LSA可视化好。研究SSI患者发生END与LSA可视化程度之间的关系。 结果 本次研究共纳入77例患者,其中END组16例(20.78%),非END组61例(79.22%)。患者平均(62.21±11.03)岁,男性51例(56.7%)。END组入院时NIHSS评分[(6.13±2.09)分 vs.(5.08±1.76)分,P=0.046]、TC[(4.93±1.17)mmol/L vs.(4.34±0.76)mmol/L,P=0.018]、LDL-C[(2.92±0.69)mmol/L vs.(2.28±0.53)mmol/L,P=0.003]和LSA可视化差(50.0% vs. 18.0%,P=0.026)均高于非END组。多因素logistic回归分析显示,高LDL-C水平 (OR 5.008,95%CI 1.305~19.224,P=0.019)和LSA可视化差(OR 8.673,95%CI 1.094~68.788,P=0.041)是患者发生END的独立危险因素。 结论 高LDL-C水平和LSA可视化差是SSI且无脑大动脉狭窄患者发生END的独立危险因素。 Abstract: Objective To study the relationship between early neurological deterioration (END) and the morphology of lenticulostriate artery (LSA) in patients with single subcortical infarction (SSI) by using the whole brain magnetic resonance vessel wall imaging (MR VWI). Methods The clinical data of patients with SSI without middle cerebral artery stenosis from Department of Neurology of Handan Central Hospital from October 2020 to January 2022 were retrospectively analyzed. Patients were divided into END group and non-END group according to occurring END or not. The visualization degree of LSA was evaluated by whole brain MR VWI. The LSA not seen in the basal ganglia was marked as poor visualization of LSA; the LSA covering less than half of the basal ganglia was marked as partial visualization of LSA; the LSA covering more than half of the basal ganglia was marked as good visualization of LSA. The correlation between END and visualization degree of LSA in patients with SSI was analyzed. Results A total of 77 patients were included in this study, with an average age of 62.21±11.03 years and 51 males (56.7%). There were 16 patients (20.78%) in the END group and 61 patients (79.22%) in the non-END group. At the baseline, compared with the non-END group, the END group had a higher NIHSS score at admission (6.13±2.09 vs. 5.08±1.76, P=0.046), higher level of TC [(4.93±1.17) mmol/L vs. (4.34±0.76) mmol/L, P=0.018] and LDL-C [(2.92±0.69) mmol/L vs. (2.28±0.53) mmol/L, P=0.003] and a higher proportion of poor visualization of the LSA [8 (50.0%) vs. 11 (18.0%), P=0.026]. Multivariate logistic regression analysis showed that the high LDL-C level (OR 5.008, 95%CI 1.305-19.224, P=0.019) and poor visualization of LSA (OR 8.673, 95%CI 1.094-68.788, P=0.041) were independent risk factors for END. Conclusion High LDL-C level and poor visualization of LSA were independent risk factors for END in patients with SSI and without middle cerebral artery stenosis.
- Published
- 2023
- Full Text
- View/download PDF