急性缺血性脑卒中患者超早期磁共振血管造影对判断预后的价值

Value of ultra-early magnetic resonance angiography in judging prognosis of acute ischemic stroke

目的探讨急性缺血性脑卒中患者超早期磁共振血管造影（MRA）所示有无大血管闭塞对判断预后的价值。方法选择在超早期（发病6h内）完成MRA检查的急性缺血性脑卒中患者44例，根据MRA显示，将患者分为大血管闭塞组和无大血管闭塞组。患者行MRA检查前完成美国国立卫生研究院卒中量表评分，在3个月时，随访改良的Ranking量表（mRS）评分。结果44例患者中大血管闭塞组21例，无大血管闭塞组23例，两组3个月随访时，mRS0-2分的比例分别为28．6％和82．6％，两组临床结局的差异有显著性意义（P〈0．001）。结论急性缺血性脑卒中患者超早期MRA所示有无大血管闭塞可帮助判断患者的预后。

Objective To evaluate the value of ultra-early MR angiography in the judgement of the prognosis of acute ischemic stroke patients. Methods The acute ischemic stroke patients who underwent MR angiography within 6 hours after onset were studied. Before MR was performed, National Institutes of Health Stroke Scale （NIHSS） scores were obtained. All patients were followed for three months after onset and modified ranking scale （mRS） scores were recorded. Results Between June 2005 and March 2006, 44 stroke patients fulfilled all inclusion criteria. Time from symptom onset to MR angiography ranged from 84 to 348 minutes. In 21 patients with visible occlusion on ultra-early MR angiography, after three months, mRS was ≤ 2 in only 6 patients, indicating a poor outcome in this group. In 23 patients without visible occlusion, after three months, mRS was ≤ 2 in 19 patients. The difference of clinical outcome between the two groups was significant（ P 〈 0.001）. Conclusions Whether there is visible occlusion on ultra-early MR angiography or not may help in judging the prognosis of acute ischemic stroke patients.