王開+王海軍

【摘要】 目的：分析新發(fā)孤立性腦橋梗死不同的形態(tài)學(xué)部位與患者急性期發(fā)生神經(jīng)功能缺損進(jìn)展的相關(guān)性。方法：對(duì)2012年2月-2016年2月收治的新發(fā)孤立性腦橋梗死168例患者臨床資料進(jìn)行回顧性分析，患者均經(jīng)MRI確診，按患者是否出現(xiàn)急性期的神經(jīng)功能缺損進(jìn)展分成進(jìn)展組和未進(jìn)展組，分析兩組患者臨床特征、實(shí)驗(yàn)室指標(biāo)、形態(tài)學(xué)部位差別及不同的形態(tài)學(xué)部位與神經(jīng)功能缺損進(jìn)展相關(guān)性。結(jié)果：新發(fā)孤立性腦橋梗死168例患者中，進(jìn)展組占26.8%（45/168），未進(jìn)展組占73.2%（123/168）。與未進(jìn)展組比較，進(jìn)展組在女性患者[57.8%（26/45） vs 43.1%（53/123）， x2=5.137]、吸煙[13.3%（6/45） vs 26.8%（33/123）， x2=5.092]、住院時(shí)間[（22.9±7.1）d vs （16.9±7.3）d，t=6.137]、短期預(yù)后不良比例[77.8%（35/45） vs 33.3%（41/123）， x2=31.812]、腦橋下部梗死率[44.4%（20/45） vs 30.1%（37/123）， x2=6.038]，差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）。經(jīng)Logistic回歸分析提示下部梗死是該類患者急性期出現(xiàn)神經(jīng)功能缺損進(jìn)展獨(dú)立的危險(xiǎn)因素[OR=1.953，95%CI（1.092，3.535），P=0.029]。結(jié)論：新發(fā)孤立性腦橋梗死患者形態(tài)學(xué)中下部梗死可以作為預(yù)測(cè)急性期出現(xiàn)神經(jīng)功能缺損進(jìn)展的一個(gè)指標(biāo)。

【關(guān)鍵詞】 腦橋梗死； 神經(jīng)功能缺損； 急性期； 彌散加權(quán)成像

Relationship between Different Topographic Location and Neurological Deterioration in Acute New Isolated Pontine Infarction/WANG Kai，WANG Hai-jun.//Medical Innovation of China，2017，14（11）：001-004

【Abstract】 Objective：To discuss the relationship between different topographic location and neurological deterioration（ND）in patients with acute new isolated pontine infarction.Method：168 patients with acute new isolated pontine infarction from February 2012 to February 2016 and identified by diffusion weighted imaging（OWI），were included for retrospective review.Patients were divided into two groups according to their clinical symptoms：the patients with ND group and thepatients without ND group.The correlations of ND with risk factors，laboratory examination results，clinical manifestations and different topographic locations were analysed by statistical tests.Rusult：Among 168 patients，26.8%（45/168）were diagnosed with ND，73.2%（123/168） were diagnosed without ND.Univariate analysis showed that there were differences in female ratio[57.8%（26/45） vs 43.1%（53/123）， x2=5.137]，smoking ratio[13.3%（6/45）vs 26.8%（33/123），x2=5.092]，mean length of hospital stay[（22.9±7.1）d vs （16.9±7.3）d，t=6.137]，ratio of worse short-term clinical outcomes[77.8%（35/45） vs 33.3%（41/123），x2=31.812] and ratio of lower pontine infarction[44.4%（20/45） vs 30.1%（37/123），

x2=6.038] between two groups （P<0.05）.Logistic regression analysis showed that lower pontine infarction was the independent risk factor of ND[OR=1.953，95%CI（1.092，3.535），P=0.029].Conclusion：Topographic location of lower pons lesions may be reliable predictor of ND in acute new isolated pontine infarction.

【Key words】 Pons infarction； Neurological deterioration； Acute stage； Diffusion weighted imaging

First-authors address：General Hospital of Fushun Mining Group，F(xiàn)ushun 113008，China