缺血性卒中患者按牛津郡社区卒中规划分型与预后关系的临床研究

A prospective cohort clinical study of classification and 6 month outcome of acute ischemic stroke subtypes according to OCSP criteria

目的按照牛津郡社区卒中规划(OxfordshireCommunityStrokeProject,OCSP)病因分型的构成,分析缺血性卒中住院患者不同亚型与预后的关系。方法采用前瞻性队列研究方法,连续性登记2004年1～7月入院的缺血性卒中患者,按照OCSP标准进行分型,分析OCSP各亚型与预后的关系。结果共纳入缺血性卒中患者197例。OCSP各亚型构成比为:全前循环梗死10.2%,部分前循环梗死26.9%,后循环梗死19.3%和腔隙性梗死43.6%。各型6个月末病死率比较,全前循环梗死占27.6%,腔隙性梗死占1.1%,有显著性差异(P<0.05)。各型6个月末Barthel指数评分比较,腔隙性梗死最高(45.2%),全前循环梗死最低(7.4%),有显著性差异(P<0.05)。各型6个月末复发例数均较少,结论尚待进一步验证。结论OCSP分型作为一种缺血性卒中根据临床表现分型方法,可以为缺血性卒中的预后估计提供参考依据。

Objective To investigate the proportion and prognosis of isehemic stroke subtypes according to OCSP criteria. Methods Data were collected prospectively from consecutive stroke inpatients in Beijing Military General Hospital from January to July 2004. After completing medical records and auxiliary diagnostic studies, all included patients were classified into 4 major ischemic stroke subtypes based on OCSP criteria. Comparing disability, death, and recurrence of OCSP subtypes with prognosis after ischemic stroke. Results 197 patients were included in this study.The proportion of ischemic stroke subtypes according to OCSP criteria was as follows ：total anterior circulation infarct （TACI）10.2%, partial anterior circulation infarct （PACI） 26.9%, posterior circulation infarct （POCI） 19.3% and lacunas infarct （LACI）43.6%. LACI was the most frequent subtype among the other subtypes and was associated with the lowest stroke severity and morbidity ,and had the best outcome. TACI had the worst outcome and highest morbidity among OCSP subtypes. The recurrence rate was low. Conclusions The OCSP classification can be used to evaluate difference of acute neurological impairment and 6-month outcome of patients with ischemic stroke. It is feasible to use OCSP criterion in China.