SWI扫描对不同程度脑微出血急性脑梗死患者 预后水平预测价值

Prognostic value of SWI scan in patients with acute cerebral infarction with different degrees of cerebral microhemorrhage

目的探讨磁敏感加权成像(SWI)扫描对不同程度脑微出血急性脑梗死患者预后水平预测价值。方法选取2019年1月至2020年2月江西医学高等专科学校第一附属医院收治的110例急性脑梗死患者作为研究对象,依据是否伴有脑微出血将其分为研究组(60例,伴脑微出血)和参照组(50例,单纯急性脑梗死);其中研究组患者根据脑微出血数量分为轻度组(18例,微出血数1~5个)、中度组(28例,微出血数6~14个)以及重度组(14例,微出血数≥15个);针对所有患者于临床合理展开静脉溶栓治疗;就出血性转化情况利用SWI扫描加以观察;比较四组患者美国国立卫生研究院脑卒中量表(NIHSS)评分以及改良RANKIN量表(mRS)评分。结果治疗前,四组患者的NIHSS评分比较,差异无统计学意义(P>0.05);四组治疗后1、14 d NIHSS评分低于治疗前,差异有统计学意义(P<0.05);四组的mRS评分占比比较,差异无统计学意义(P<0.05)。四组的出血性转化发生率比较,差异有统计学意义(P<0.05)。结论急性脑梗死患者在伴有中重度脑微出血情况后,会增加出血性转化发生率,使患者预后水平受到严重影响,对此SWI扫描方式有效运用,可充分明确患者脑微出血情况,可为临床溶栓治疗提供有力依据。

Objective To investigate the prognostic value of magnetic sensitivity weighted imaging(SWI)in patients with acute cerebral infarction with different degrees of microhemorrhage.Methods A total of 110 patients with acute cerebral infarction admitted to the First Affiliated Hospital of Jiangxi Medical College from January 2019 to February 2020 were selected as the research subjects.They were divided into study group(60 cases,cerebral microhemorrhage)and control group(50 cases,simple acute cerebral infarction)according to the presence or not of cerebral microhemorrhage.According to the number of microbleeds in the study group,the patients were divided into mild group(18 cases,1-5 microbleeds),moderate group(28 cases,6-14 microbleeds)and severe group(14 cases,≥15 microbleeds).Intravenous thrombolytic therapy was carried out reasonably in all patients.The hemorrhagic transformation was observed by SWI scan.The national institutes of health stroke scale(NIHSS)scores and the modified rankin scale(MRS)scores were compared in the four groups.Results There was no significant difference in NIHSS scores among 4 groups before treatment(P>0.05).NIHSS scores at 1 and 14 days after treatment in the four groups were lower than those before treatment,and the differences were statistically significant(P<0.05).There was no significant difference in the proportion of the mRS score among the four groups(P<0.05).There was statistically significant difference in the hemorrhagic transfromation in the four groups(P<0.05).Conclusion Patients with acute cerebral infarction accompanied by moderate to severe cerebral microhemorrhage will significantly increase the incidence of hemorrhagic transformation,which will seriously affect the prognosis of patients.The effective application of SWI scanning method can clarify the situation of cerebral microhemorrhage in patients,and provide a strong basis for clinical thrombolytic therapy.