轻度脑桥梗死后早期神经功能缺损的影响因素分析

Analysis on the influencing factors of early neurological deficit after mild pontine infarction

目的探讨轻度脑桥梗死后早期神经功能缺损的影响因素。方法选择121例轻型脑桥梗死患者为研究对象,根据美国国立卫生研究院卒中量表(NIHSS)评分分为神经功能恶化组(41例)和神经功能非恶化组(80例),回顾性收集、比较两组患者一般资料、实验室检查及影像学相关资料结果,并进行logistic回归分析。结果两组患者间糖尿病史、空腹血糖、出院时NIHSS评分、梗死部位、梗死灶分布、梗死层面最大直径、基底动脉狭窄、脑室旁脑白质高信号(WMH)及皮质下WMH差异有统计学意义(P<0.05)。logistic回归分析显示,脑桥下部梗死、累及脑桥腹侧表面梗死、基底动脉狭窄≥50%、脑室旁重度WMH、皮质下重度WMH为神经功能恶化的独立影响因素(P<0.05)。结论脑桥下部梗死、累底脑桥腹侧表面梗死、基底动脉狭窄≥50%、脑室旁重度WMH、皮质下重度WMH为轻度脑桥梗死患者神经功能恶化的独立影响因素。

Objective To analyze the factors of early neurological deficit after mild pontine infarction.Methods A total of 121 patients who underwent mild pontine infarction were selected and divided into the neurodegenerative group(n=41)and the non-malignant neurologic group(n=80)according to the score of the national institutes of health stroke scale(NIHSS).The general data,laboratory examination and imaging data of two groups were collected and compared retrospectively.In addition,logistic regression analysis was performed based on this information.Results Statistical difference was found in the history of diabetes mellitus,fasting blood glucose,score of NIHSS at discharge,location of infarction,distribution of infarction focus,maximum diameter of infarction plane,stenosis of base artery,paraventricular white matter hyperintense(WMH)and subcortical WMH between two groups.According to the results of logistic regression analysis,inferior pontine infarction,accumulative infarction on the ventral surface of pontine,basilar artery stenosis≥50%,severe paraventricular WMH,subcortical severe WMH were independent factors of neurological deterioration(P<0.05).Conclusion Inferior pontine infarction,accumulative infarction on the ventral surface of pontine,basilar artery stenosis≥50%,severe paraventricular WMH and subcortical severe WMH are independent factors of neurological deterioration in patients with mild pontine infarction.