2021 年第 5 期 第 16 卷

卒中预警综合征患者早期神经功能恶化与磁共振成像特征的相关性

Correlation between early neurological deterioration and magnetic resonance imaging characteristics in patients with stroke warning syndrome

作者：刘磊1唐晓梅1冯研1史冬梅1孟晓梅1李小刚2

英文作者：Liu Lei1 Tang Xiaomei1  Feng Yan1 Shi Dongmei1  Meng Xiaomei1 Li Xiaogang2

单位：1北京大学第三医院海淀院区北京市海淀医院神经内科100086；2北京大学第三医院神经内科100086

英文单位：1Department of Neurology Haidian Section of Peking University Third Hospital Beijing Haidian Hospital Beijing 100086 China; 2Department of Neurology Peking University Third Hospital Beijing 100086 China

关键词：卒中预警综合征；早期神经功能恶化；磁共振成像

英文关键词：Strokewarningsyndrome;Earlyneurologicaldeterioration;Magneticresonanceimaging

• 摘要：

• 目的 探讨卒中预警综合征（SWS）患者早期神经功能恶化（END）与磁共振成像（MRI）特征的关系。方法 回顾性分析2015年10月至2020年10月于北京市海淀医院诊治的32例SWS患者的临床资料。根据入院7 d内是否发生END，分为END 组（21例）和非END组（11例）。收集患者的基线资料。所有患者发病7 d内完善颅脑MRI检查，比较2组梗死病灶≥2层、责任血管穿支病变比例。随访3个月，比较2组患者功能预后不良比例。采用多因素Logistic回归方法 分析SWS患者发生END的独立危险因素。结果 2组年龄、性别、吸烟史、饮酒史、冠状动脉粥样硬化性心脏病、心房颤动、高血压、糖尿病比例，体重指数、总胆固醇、三酰甘油水平以及肺部感染、泌尿系感染、消化道出血、下肢静脉血栓、责任血管穿支病变比例比较，差异均无统计学意义（均P＞0.05）。END组梗死病灶≥2层比例、功能预后不良比例均高于非END组［81.0%（17/21）比18.2%（2/11）、57.1%（12/21）比0(0/11)］，差异有统计学意义（均P＜0.01）。Logistic回归分析结果 显示，梗死病灶≥2层是SWS患者发生END的独立危险因素（比值比=33.489，95%置信区间：2.705~414.670，P=0.006）。结论 颅脑MRI梗死病灶≥2层是SWS患者发生END的独立危险因素，存在END者更易出现功能预后不良。

• Objective To investigate the correlation between early neurological deterioration (END) and magnetic resonance imaging (MRI) characteristics in patients with stroke warning syndrome (SWS). Methods From October 2015 to October 2020, clinical data of 32 patients with SWS admitted to Beijing Haidian Hospital were retrospectively analyzed. According to the occurrence of END within 7 d after admission, the patients were divided into END group(21 cases) and non-END group(11 cases). The baseline data of patients were collected. All patients were examined with brain MRI within 7 d after onset, and the rates of infarct lesion≥2 layers and responsible vascular perforator lesion were compared between the two groups. Patients were followed-up for 3 months, and the rate of poor functional prognosis were compared. Multivariate Logistic regression method were used to analyze the independent risk factors of END in SWS patients. Results There were no differences in age, rates of gender, smoking history, alcohol history, coronary atherosclerotic heart disease history, atrial fibrillation, hypertension and diabetes mellitus, and body mass index, total cholesterol, triacylglycerol levels, as well as rates of pulmonary infection, urinary infection, gastrointestinal bleeding, venous thrombosis of lower limbs and responsible vascular perforator lesion between the two groups(all P>0.05). The rates of infarct lesion≥2 layers and poor functional prognosis in END group were higher than those in non-END group［81.0%（17/21） vs 18.2%（2/11）, 57.1%（12/21） vs 0(0/11)］(both P<0.01). Logistic regression analysis showed that infarct lesion≥2 layers was a independent risk factor for END in SWS patients(odds radio=33.489, 95% confidence interval: 2.705-414.670, P=0.006). Conclusions Brain MRI infarct lesion≥2 layers is a independent risk factor for END in SWS patients. Patients with END are more likely to have poor functional prognosis.