急性动脉粥样硬化型脑梗死患者脑血流储备能力与患者近期预后的关系

Relationship between cerebral blood flow reserve capacity and short-term prognosis in patients with acute atherosclerotic cerebral infarction

目的探究急性动脉粥样硬化型脑梗死(AACI)患者脑血流储备能力与患者近期预后的关系。方法前瞻性选取2017年3月至2018年3月韩城市人民医院收治的124例AACI患者作为研究对象,其中62例预后良好者为预后良好组,62例预后不良者为预后不良组,另选同时期体检正常者62例作为对照组;收集脑梗死患者的临床资料,多普勒超声(TCD)检测入试者脑血流储备能力,并采用Logistic分析脑梗死患者脑血流储备指标和预后关系。结果预后良好组患者的入院美国国立卫生研究院卒中量表(NIHSS)评分、白细胞计数(WBC)分别为(2.50±0.50)分、(6.95±1.15)×10^9/L,明显低于预后不良组的(4.50±0.50)分、(10.70±1.50)×10^9/L,差异均有统计学意义(P<0.05);对照组受检者的血流储备能力正常者占比为35.48%,明显高于预后良好组的19.35%和预后不良组的3.23%,而预后良好组患者血流储备能力正常者明显高于预后不良组,差异有统计学意义(P<0.05);预后良好组患者的平均血流速度(Vm)上升率、搏动指数(PI)下降率、屏气指数(BHI)分别为(15.04±2.21)%、(17.55±2.92)%、0.67±0.16,明显高于预后不良组的(7.26±2.37)%、(7.60±2.37)%、0.16±0.05,差异均有统计学意义(P<0.05);经Logistic回归分析结果显示,入院NIHSS评分、WBC、Vm上升率、PI下降率、BHI均是脑梗死患者不良预后的危险因素(P<0.05)。结论脑血流储备能力是急性动脉粥样硬化型脑梗死患者的影响因子,且预后不良患者多发生脑血管储备能力减退事件。

Objective To explore the relationship between cerebral blood flow reserve capacity and short-term prognosis of patients with acute atherosclerotic cerebral infarction(AACI). Methods A total of 124 AACI patients admitted to Hancheng People’s Hospital from March 2017 to March 2018 were prospectively selected as the study objects,including 62 patients with good prognosis(good prognosis group) and 62 patients with poor prognosis(poor prognosis group). Besides, 62 patients with normal physical examination in the same period were selected as the control group. The clinical data of patients with cerebral infarction were collected, and transcranial Doppler(TCD) was used to detect the cerebral blood flow reserve capacity. Logistic analysis was used to analyze the relationship between cerebral blood flow reserve index and prognosis. Results The NIHSS score, white blood cell count(WBC) were(2.50±0.50) points,(6.95±1.15)×10^9/L in good prognosis group, significantly lower than(4.50±0.50) points and(10.70±1.50)×10^9/L in poor prognosis group(P<0.05). The proportion of subjects with normal blood flow reserve capacity in the control group was 35.48%,significantly higher than 19.35% in the good prognosis group and 3.23% in the poor prognosis group, and proportion in the good prognosis group were significantly higher than that in the poor prognosis group(P<0.05). The mean velocity(Vm) ascending rate, pulsatility index(PI) descending rate, and breath-holding index(BHI) in the good prognosis group were(15.04±2.21)%,(17.55±2.92)% and 0.67±0.16, respectively, which were significantly higher than(7.26±2.37)%,(7.60 ± 2.37)%, and 0.16 ± 0.05 in the poor prognosis group(P<0.05). Logistic regression analysis showed that NIHSS score, WBC, Vmascending rate, PI descending rate, and BHI were all risk factors for poor prognosis of cerebral infarction patients(P<0.05). Conclusion Cerebral blood flow reserve capacity was an influential factor in patients with acute atherosclerotic cerebral infarction.