豆纹动脉供血区孤立性梗死的病灶位置与短期预后的关系

Lesion location and short outcome among patients with single infarction in the lenticulostriate artery territory

目的研究豆纹动脉供血区孤立性梗死患者病灶位置的不同对其短期预后的影响。方法采用头颅MRI检查测定198例急性豆纹动脉供血区孤立性梗死患者的梗死灶最大直径、病灶位置及动脉供血分布情况。发病14 d时,采用mRS量表评定患者的预后。结果患者出现预后不良的概率为:远端梗死组10例(11.4%),前部近端梗死组6例(20.0%),中部近端梗死组6例(27.3%),后部近端梗死组36例(62.1%)。线性趋势χ~2检验显示,从远端梗死到后部近端梗死预后不良发生的概率逐渐上升(P<0.05),非条件Logistic回归分析显示,后部近端梗死组预后不良的危险性是远端梗死组的24.801倍(OR=24.801,95%CI:2.521~243.942,P=0.006)。结论豆纹动脉供血区孤立性梗死的病灶位置越靠后,预后不良发生率越高,病灶位置可作为短期预后不良的预测指标。

Objective To investigate the relationship between lesion location and short outcome among patients with single infarction in the lenticulostriate artery(LSA)territory.Methods The maximal diameter of the infarct lesion,lesion location and arterial blood supply distribution in 198 patients with acute single infarction in the LSA were examined by brain MRI.Recovery of patients was assessed by mRS at 14 days follow-up.Results The number of patients with poor short outcome was as follows:distal type 10(11.4%),anterior proximal type 6(20.0%),intermediate proximal type 6(27.3%)and posterior proximal type 36(62.1%).The Linear-by-Linear Association showed a significant increase through distal type to posterior proximal type(P<0.05).Non-conditional Logistic regression analysis showed that the risk of poor prognosis in posterior proximal type was 24.801 times higher than distal type(OR=24.801,95%CI:2.521-243.942,P=0.006).Conclusions The more posterior the infarct location,the more frequent is the poor outcome that occurred.Lesion location is valuable in predicting the incidence of poor short outcome in patients with single infarction in LSA.