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白质疏松症对老年急性脑梗死患者神经功能恢复的影响:一项纳入279例中国患者的临床研究。

The impact of leucoaraiosis on neurological function recovery in elderly patients with acute cerebral infarction: Clinical study involving 279 Chinese patients.

作者信息

Huang Yong-hua, Xia Zhen-xi, Wei Wei, Gao Guan-ran, Gong Jing-jing, Li Ying, Zhang Wei-wei

机构信息

Department of Neurology, Beijing Military General Hospital, Beijing, China.

Department of Neurology, Beijing Military General Hospital, Beijing, China

出版信息

J Int Med Res. 2014 Jun;42(3):857-62. doi: 10.1177/0300060513507386. Epub 2014 Apr 24.

Abstract

OBJECTIVE

To explore the link between leucoaraiosis and recovery of neurological function in elderly patients with acute cerebral infarction.

METHODS

The study included elderly patients, hospitalized with acute cerebral infarction. Magnetic resonance imaging examinations were performed before or within 5 days after admission; T1-weighted, T2-weighted, fluid-attenuated inversion recovery and diffusion-weighted imaging sequence data were collected. Using the Fazekas scale, leucoaraiosis (white matter hyperintensity [WMH]) was graded as 0 (absent), 1 (mild), 2 (moderate) or 3 (severe) for all participants.

RESULTS

The study included 279 patients. WMH grades of 0, 1, 2 and 3 were seen in 27 (9.67%), 90 (32.26%), 104 (37.28%) and 58 cases (20.79%) respectively. Improvement on the National Institutes of Health Stroke Scale for neurological impairment was negatively associated with WMH grade. Patients with severe leucoaraiosis at hospital admission had worse neurological functional recovery and a higher rate of self-care incapability compared with those with mild or no leucoaraiosis.

CONCLUSIONS

The results suggest that severe leucoaraiosis in elderly patients with acute cerebral infarction is associated with poor prognosis and poor recovery of neurological function.

摘要

目的

探讨老年急性脑梗死患者脑白质疏松症与神经功能恢复之间的联系。

方法

本研究纳入因急性脑梗死住院的老年患者。入院前或入院后5天内进行磁共振成像检查;收集T1加权、T2加权、液体衰减反转恢复和扩散加权成像序列数据。对所有参与者使用 Fazekas量表,将脑白质疏松症(白质高信号[WMH])分为0级(无)、1级(轻度)、2级(中度)或3级(重度)。

结果

本研究纳入279例患者。WMH分级为0级、1级、2级和3级的分别有27例(9.67%)、90例(32.26%)、104例(37.28%)和58例(20.79%)。美国国立卫生研究院卒中量表神经功能缺损改善情况与WMH分级呈负相关。与轻度或无脑白质疏松症的患者相比,入院时脑白质疏松症严重的患者神经功能恢复较差,自理能力丧失率更高。

结论

结果表明,老年急性脑梗死患者严重脑白质疏松症与预后不良和神经功能恢复差有关。

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