Jacquin A, Virat-Brassaud M-E, Rouaud O, Osseby G-V, Aboa-Eboulé C, Hervieu M, Ménassa M, Ricolfi F, Giroud M, Béjot Y
Department of Neurology, Memory Centre, University Hospital, Dijon, France.
Eur Neurol. 2014;71(5-6):288-95. doi: 10.1159/000357428. Epub 2014 Feb 26.
No data about the specific outcome of aphasia after thrombolysis are available. Our aim was to describe the severity and type of aphasia after stroke thrombolysis.
This retrospective cohort study included consecutive aphasic patients hospitalized in the Stroke Unit of Dijon (University Hospital, France) between 2004 and 2009 for a first-ever ischemic stroke of the left middle cerebral artery. Aphasic syndromes and their severity (French version of the Boston Diagnostic Aphasia Examination) were evaluated during the first week and 3 months after stroke.
In multivariate analyses, the severity of aphasia in the 37 thrombolysed patients was milder than in the 38 nonthrombolysed patients during the first week (adjusted OR = 10.13, 95% CI: 2.43-42.28, p = 0.002) and at 3 months (adjusted OR = 8.44, 95% CI: 2.76-25.80, p = 0.001). The frequency of mild aphasia (conduction or atypical) was not significantly higher in thrombolysed patients during the first week after stroke (adjusted OR = 5.80, 95% CI: 0.82-41.16, p = 0.079).
The severity of aphasia during the first week and 3 months after stroke is milder in thrombolysed than in nonthrombolysed patients, perhaps because of a greater frequency of conduction and mild atypical aphasia.
目前尚无关于溶栓治疗后失语症具体转归的数据。我们的目的是描述中风溶栓治疗后失语症的严重程度和类型。
这项回顾性队列研究纳入了2004年至2009年间在法国第戎大学医院卒中单元住院的连续性失语患者，这些患者均为首次发生的左大脑中动脉缺血性卒中。在卒中后的第一周和3个月评估失语综合征及其严重程度（采用波士顿失语诊断检查法法语版）。
在多变量分析中，37例接受溶栓治疗的患者在第一周（调整后的比值比=10.13，95%置信区间：2.43 - 42.28，p = 0.002）和3个月时（调整后的比值比=8.44，95%置信区间：2.76 - 25.80，p = 0.001）失语症的严重程度比38例未接受溶栓治疗的患者轻。溶栓治疗的患者在卒中后第一周轻度失语（传导性或非典型性）的发生率没有显著更高（调整后的比值比=5.80，95%置信区间：0.82 - 41.16，p = 0.079）。
卒中后第一周和3个月时，接受溶栓治疗的患者失语症的严重程度比未接受溶栓治疗的患者轻，这可能是由于传导性和轻度非典型性失语的发生率更高。
