急性脑梗死TOAST分型、MRI分型与短期预后的关系

Study of the correlation between TOAST, MRI classification and short-term prognosis of acute cerebral infarction

目的:探讨急性脑梗死TOAST分型、MRI分型与短期预后的关系。方法:收集2013年2月至2014年3月在河北联合大学附属医院神经内二科住院的急性脑梗死患者340例,按分型标准进行TOAST分型及MRI分型,比较不同亚型间入院时和发病1个月后的NIHSS评分及好转率。结果:经多因素Logistic相关性分析,调整年龄、高血压病史、高纤维蛋白原血症等因素后,TOAST分型与急性脑梗死短期预后显著相关(wals=39.402,P<0.001),但加入MRI分型调整后,TOAST分型与预后的相关性消失(wals=8.124,P=0.087),而MRI分型与预后显著相关(wals=56.487,P<0.001)。结论 :TOAST分型及MRI分型对急性脑梗死的短期预后均有一定的预测作用,MRI分型的预测作用优于TOAST分型,且两种分型联合使用并不提高预测效果。

Objective Explore the correlation between TOAST, MRI classification and short-term prognosis of acute cerebral infarction. Methods 340 cases of patients with acute cerebral infarction in Hebei united university affiliated hospital from February 2013 to March 2014 were classified by TOAST and MRI,NIHSS score and the recovery rate on admission and after 1 month of the two different subtypes were compared. Result By muhivariable Logistic correlation analysis, adjustment for age, hypertension and high blood fibrinogen factors, TOAST classification is associated with a significant short-term prognosis of acute cerebral infarction （wals = 39.402,P 〈 0.001）, whereas TOAST classification and prognosis of the correlation disappeared after joining the MRI classification （wals = 8.124, P = 0.087）, but MRI classification is significantly associated with prognosis （wals = 56.487,P 〈 0.001）. Conclusion TOAST classification and MRI classification both has certain prediction effect in the short-term prognosis of acute cerebral infarction, MRI classification prediction effect is superior to TOAST, and using of two kinds of classification does not improve the prediction effect.