脑白质疏松对脑梗死预后的影响

Effect of leukoaraiosis on prognosis of cerebral infarction

目的:探讨脑白质疏松(LA)对脑梗死预后的影响。方法:将在发病48h内住院的173例急性脑梗死患者按照是否伴有LA分为伴LA组(63例)与单纯脑梗死组(110例),并随访1a,分别于入院时,治疗后1、6、9个月及1a时行中国脑卒中临床神经功能缺损程度(CSS)、日常生活能力评定Barthel指数(BI)、简易精神状态量表(MMSE)测评,并统计脑梗死复发率。结果:2组患者随访期内CSS评分、BI、MMSE评分组内效应、组间效应及交互效应差异均有统计学意义。2组入院时及治疗后1个月、3个月时CSS、BI及MMSE评分差异无统计学意义(P>0.05)。治疗后6个月以后脑梗死伴LA组CSS评分高于单纯脑梗死组,BI及MMSE评分低于单纯脑梗死组(P<0.05)。随访1a,脑梗死伴LA组脑梗死复发时间(10.651±0.037)个月(95%CI为9.926～11.376个月),单纯脑梗死组为(11.464±0.173)个月(95%CI为11.125～11.802个月),脑梗死伴LA组脑梗死复发时间早于单纯脑梗死组(χ2L=4.964,P=0.026)。结论:LA对脑梗死的预后有明显影响,且增加复发风险。

Aim：To study the effect of leukoaraiosis（LA） on prognosis of cerebral infarction.Methods：A total of 173 patients with acute cerebral infarction within 48 h were divided into co-LA group（63 cases） and non-LA group（110 cases）.The Chinese Stroke Scale（CSS） score,Barthel Index（BI） of daily living assessment,the mini-mental state examination（MMSE） score and the recurrence were recorded at admission,1,3,6,9 months and 1 a after admission.Results：There were significant differences in CSS,BI and MMSE score between the two groups at different time points（P0.05）.There was no significant difference between the two groups in CSS,BI and MMSE score at admission and 3,6 months after the admission（P0.05）.At 6,9 months and 1 a after the admission,co-LA group had higher CSS score,lower BI and MMSE score compared with non-LA group（P0.05）.During one-year follow-up,the time of recurrence of cerebral infarction in co-LA group was（10.651±0.037） months（95%CI was 9.926～11.376 months）,significantly higher than that（11.464±0.173） months（95% CI was 11.125～11.802 months） in non-LA group（χ2L=4.964,P=0.026）.Conclusion：LA may increases the recurrence risk of cerebral infarction.