脑梗死患者脑血管反应性与神经功能缺损及预后的相关性

The correlation between neurologic impairment prognosis and cerebral vasoreactivity in patients with cerebral infarction

目的探讨脑梗死患者脑血管反应性(cerebral vasoreactivity,CVR)与神经功能缺损及预后的相关性。方法以120例脑梗死患者作为病例组,以120例健康体检者作为对照组。入院时NIHSS≤4、5～20和> 20分作为轻度组(53例)、中度组(42例)和重度组(25例)。TCD屏气试验测定CVR。结果病例组左侧MCA和右侧MCA的BHI明显低于对照组(P <0. 05)。中重度组左侧MCA和右侧MCA的BHI较轻度组明显降低,重度组上述指标较中度组明显降低(P <0. 05)。病例组BHI与NIHSS评分呈负相关,而与BI评分呈正相关(P <0. 05)。结论 CVR能反映脑梗死患者神经功能缺损程度,并可作为预后状况的评价指标,为脑梗死的临床防治提供参考意义。

Objective To study the correlation between neurologic impairment,prognosis and cerebral vasoreactivity (CVR) in patients with cerebral infarction.Methods 120 cases patients with cerebral infarction were as cases group,120 of healthy physical examination were as control group.NIHSS ≤4,5~20 and>20 were as mild group (n=53),moderate group (n=42) and severe group (n=25).CVR was examined by TCD breath-holding test.Results BHI in the left and right side MCA of cases group were significantly lower than the control group (P<0.05).BHI in the left and right side MCA of moderate-severe groups were significantly decreased while compared with mild group,above indexes of severe group were significantly decreased while compared with moderate group (P<0.05).BHI in cases group were negatively correlated with NIHSS score,but were positively correlated with BI (P<0.05).Conclusion CVR can reflect neurologic impairment in patients with cerebral infarction,and can be used as a predictor of prognosis,and provide reference for the clinical prevention and treatment of cerebral infarction.