皮质静脉征与急性脑梗死进展的相关研究

Relationship between cortical vein sign and ACI progression

目的探讨磁敏感加权成像皮质静脉征与急性脑梗死进展的关系及影响因素。方法选择2019年8月~2021年5月南京市江宁医院神经内科住院的老年急性脑梗死患者130例,根据美国国立卫生研究院卒中量表(NIHSS)评分分为非进展组98例和进展组32例。比较非进展组与进展组一般临床资料和影像学检查,并进一步行多因素logistic回归分析皮质静脉征在急性脑梗死进展中的作用。又根据皮质静脉征情况分为减少组19例,正常组72例及增多组39例,比较3组入院时NIHSS评分、发病7 d NIHSS评分、大血管狭窄及急性脑梗死进展情况。结果进展组LDL-C、TC、发病7 d NIHSS评分、大血管狭窄和皮质静脉征增多比例明显高于非进展组,差异有统计学意义(P<0.05,P<0.01)。多因素logistic回归分析显示,皮质静脉征增多是急性脑梗死进展的独立危险因素(OR=8.412,95%CI:3.018~23.448,P=0.000)。减少组、正常组及增多组发病7 d NIHSS评分、大血管狭窄及急性脑梗死进展比例比较,差异有统计学意义(P<0.01)。结论皮质静脉征增多与急性脑梗死进展密切相关,是预测急性脑梗死患者预后的有效指标。

Objective To study the relationship between cortical vein sign on susceptibility-weighted imaging and acute cerebral infarction(ACI)progression.Methods One hundred and thirty elderly ACI patients admitted to our hospital from August 2019 to May 2021 were divided into ACI progression-free group(n=98)and ACI progression group(n=32)according to their NIHSS score.Their general clinical data and imaging parameters were recorded and compared.The role of cortical vein sign in ACI progression was analyzed by multivariate logistic regression analysis.The patients were further divided into reduced cortical vein sign group(n=19),normal cortical vein sign group(n=72)and increased cortical vein sign group(n=39).The NIHSS score,ratio of large vessel stenosis and ACI progression in 3 groups were compared.Results The serum LDL-C and TC levels,NIHSS score on day 7 after onset of ACI,ratio of large vessel stenosis and cortical vein sign were significantly higher in ACI progression group than in ACI progression-free group(P<0.05,P<0.01).Multivariate logistic regression analysis showed that increased cortical vein sign was an independent risk factor for ACI progression(OR=8.412,95%CI:3.018-23.448,P=0.000).Significant difference was detected in NIHSS score on day 7 after onset of ACI,ratio of large vessel stenosis and ACI progression in reduced,normal and increased cortical vein sign groups(P<0.01).Conclusion Increased cortical vein sign is closely related with ACI progression and is an effective predictor of outcome in ACI patients.