Schiemanck S K, Post M W M, Witkamp Th D, Kappelle L J, Prevo A J H
Center of Excellence for Rehabilitation Medicine, Rehabilitation Center De Hoogstraat Utrecht, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, the Netherlands.
Neurorehabil Neural Repair. 2005 Jun;19(2):133-8. doi: 10.1177/154596830501900207.
To examine the relationship between the volume of the middle cerebral artery stroke lesion and functional status in the subacute phase of stroke.
Infarctvolumes of 94 patients with a 1st middle cerebral artery stroke assessed on conventional MRI scans obtained in the 2nd week poststroke were related to a clinical measure of stroke severity (National Institutes of Health Stroke Scale [NIHSS]) and to functional status: motor impairment (Motricity Index [MI]) and limitation in activities (Barthel Index [BI] and modified Rankin Scale). Separate correlations were computed for patients with large (>30 ml) and small (30 ml) lesions, and to investigate the influence of lesion location on the relationship between volume and functional status, correlations were computed for patients with left and right hemisphere lesions and for patients with cortical and subcortical lesions.
Lesion volume correlated strongly with NIHSS scores (R = 0.61) and moderately with the patient's functional status (MI [R between -0.42 and - 0.49], BI [R = -0.43], and Modified Rankin Scale [R = 0.45]). Right hemisphere lesions and cortical lesions had a stronger correlation with functional status. In patients with small lesion volumes (0-30 ml), no relationship between lesion volumes and functional status was seen at all.
Lesion volume is moderately to strongly related to the functional status in the 2nd week poststroke.
探讨大脑中动脉卒中病变体积与卒中亚急性期功能状态之间的关系。
对94例首次发生大脑中动脉卒中的患者，在卒中后第2周进行常规MRI扫描评估梗死体积，并将其与卒中严重程度的临床指标（美国国立卫生研究院卒中量表[NIHSS]）以及功能状态相关联：运动障碍（运动指数[MI]）和活动受限情况（Barthel指数[BI]和改良Rankin量表）。分别计算病变体积大（>30 ml）和小（≤30 ml）的患者的相关性，为研究病变位置对体积与功能状态关系的影响，计算左、右半球病变患者以及皮质和皮质下病变患者的相关性。
病变体积与NIHSS评分密切相关（R = 0.61），与患者功能状态中度相关（MI[R在-0.42至-0.49之间]，BI[R = -0.43]，改良Rankin量表[R = 0.45]）。右半球病变和皮质病变与功能状态的相关性更强。在病变体积小（0 - 30 ml）的患者中，未观察到病变体积与功能状态之间的关系。
病变体积与卒中后第2周的功能状态中度至密切相关。
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