改良Rankin量表在急性大面积脑梗死长期生存的预后价值

Prognostic Value of Modified Rankin Scale in the Long-term Survival in Acute Massive Cerebral Infarction

目的本研究的目的是探讨急性大面积脑梗死长期生存的预后因素。方法回顾性分析生存时间超过1个月的急性大面积脑梗死患者共42例。应用生存曲线分析可能影响急性大面脑梗死的预后因素。结果该组患者平均年龄为69.9±6.9岁,平均生存时间为41.7±4.3个月。改良Rankin量表评分≥4的患者平均生存时间为27.6±6.4个月,改良Rankin量表评分≤3的患者平均生存时间为49.0±4.9个月(P=0.022)。年龄≥69.5岁平均生存时间32.2±5.8个月,而<69.5岁组平均生存期为50.2±5.8个月(P=0.028)。其他因素如性别、高血压、心功能不全、心房纤颤、糖尿病,既往有卒中病史、吸烟、血脂异常等并不影响预后。结论年龄和卒中后1个月改良Rankin评分是影响大面积脑梗死患者长期生存的重要因素。

Objective To evaluate the prognostic factors that can influence long - term survival in patients suffered acute massive cerebral infarction. Methods We retrospectively collected 42 patients with acute massive cerebral infarction. The survival curves were used to analyze multiple prognostic factors which have potential effects on the prognosis. Results The mean age of the patients was 69.9 ：t 6.9 years and the mean survival was 41.7 ± 4.3 months. The mean survival of the poor functional outcome group （mRS ≥ 4） was 27.6± 6.4months, whereas that of the good functional outcome group （ mRS ≤ 3 ） was 49.0 ± 4.9 months （ P = 0. 022）. The mean surviv- al of the older patients （ ≥ 69.5 years） was 32.2 ± 5.8 months, whereas that of the younger patients （ 〈 69.5 years） was much better as 50. 2±5.8 months （ P = 0. 028）. Other factors as gender, hypertension, heart failure, atrial fibrillation, diabetes mellitus, a previous his- tory of stroke, smoking, dyslipidernia and etc, did not significantly influence the mean survival time in the current study. Conclusion Age and functional outcome at one month could be critical prognostic factors for survival after acute massive cerebral infarction.