急性前循环脑梗死患者病灶周围皮质静脉征的临床分析

Cortical veins sign around lesions in acute anterior circulation cerebral infarction patients

目的分析急性前循环脑梗死患者病灶周围皮质静脉征(cortical veins sign,CVS)与临床相关变量的关系。方法连续纳入2016年9月～2018年3月于安徽医科大学第三附属医院神经内科住院治疗的急性前循环脑梗死患者85例,患者行磁敏感加权成像检查,观察脑梗死病灶周围CVS的分布情况,并分为CVS正常组26例、CVS减少组14例和CVS增多组45例,分析影响CVS分布的相关因素。结果 CVS正常组、CVS减少组和CVS增多组吸烟、脑梗死体积、出院美国国立卫生研究院卒中量表评分、血管重度狭窄或闭塞比例比较,差异有统计学意义(P <0. 05,P <0. 01)。多因素logistic回归分析显示,CVS减少与吸烟(OR=0. 009,95%CI:0. 001～0. 247,P=0. 005)、脑梗死体积(OR=1. 134,95%CI:1. 007～1. 276,P=0. 037)相关;血管重度狭窄或闭塞则是CVS增多的独立危险因素(OR=5. 546,95%CI:1. 149～26. 769,P=0. 033)。结论病灶周围CVS减少与较大的脑梗死体积相关,而CVS增多与同侧颅内外血管重度狭窄或闭塞相关,未见CVS分布对患者短期临床预后有提示作用。

Objective To analyze the relationship between cortical veins sign(CVS)and related clinical variations in acute anterior circulation cerebral infarction patients.Methods Eighty-five acute anterior circulation cerebral infarction patients who underwent susceptibility-weighted imaging in our hospital were divided into normal CVS group(n=26),reduced CVS group(n=14),and increased CVS group(n=45).The factors influencing the distribution of CVS around lesions were analyzed.Results The history of smoking,volume of cerebral infarction,NIHSS score,and incidence of severe vascular stenosis or occlusion were significantly different in 3 groups(P<0.05,P<0.01).Multivariate logistic regression analysis showed that reduced CVS was related with the history of smoking and size of cerebral infarction(OR=0.009,95%CI:0.001-0.247,P=0.005;OR=1.134,95%CI:1.007-1.276,P=0.037)and servere vascular stenosis or occlusion was an indepent risk factor for increased CVS(OR=5.546,95%CI:1.149-26.769,P=0.033).Conclusion Reduced CVS around lesions is related with the larger size of cerebral infarction while increased CVS is related with ipsilateral severe internal and external cerebrovascular stenosis or occlusion.The distribution of CVS does not play a role in predicting the short-term outcome of acute anterior circulation cerebral infarction patients.