脑白质疏松症对大面积脑梗死预后的影响

Effect of the leukoaraiosis on the prognosis of massive cerebral infarction

目的探讨脑白质疏松症对大面积脑梗死预后的影响。方法收集60例首次卒中即表现为大面积脑梗死的患者的临床资料,分为合并脑白质疏松组(LA+组,30例)和不合并脑白质疏松组(LA-组,30例)。记录2组患者神经影像学表现、患者的病死率及发病2年内卒中的再发率,并根据脑卒中患者临床神经功能缺损程度评分标准和简易智能量表对患者进行神经功能和智能状态的评估。结果合并脑白质疏松症的患者平均年龄偏大,初次梗死时梗死灶的数目较多,有更严重的神经功能缺损和智能障碍,2组之间病死率没有差别。在2年随访期间,合并脑白质疏松组的患者的再次卒中和脑出血的比例均增加。2年随访结束时,合并脑白质疏松组的患者有更严重的神经功能缺损和智能障碍。结论合并脑白质疏松的大面积脑梗死患者预后比不合并脑白质疏松的大面积脑梗死患者预后差。

Objective To investigate the effect of leukoaraiosis（LA） on the prognosis of massive cerebral infarction（MI）. Methods Sixty first-ever MI patients were divided into MI with LA（LA＋ ,n=30） and MI without LA（LA- ,n=30） according to the presence of LA. The information on neuroimaging, mortality, values of neurological defects, mini-mental state examination （MMSE）, rate of recurrent stroke in the two years were recorded. Results Patients with LA were significantly older and higher incidence of multiple infarctions on neuroimaging study. They had poor functional disability and cognition. There was no significant association between LA and mortality. In the end of the follow-up period, the rate of recurrent stroke, hemorrhage, values of neurological defects, prevalence of dementia were significantly higher in LA＋ than that in LA-group. Conclusion The prognosis is less favorable in patients with LA＋ than LA-.