Perera N D, Bandara K M, Ranasinghe I R, Gunatilake S B
Department of Medicine, University of Sri Jayewardenepura, Sri Lanka.
Ceylon Med J. 2015 Sep;60(3):103-6. doi: 10.4038/cmj.v60i3.8190.
This study compares demography, risk factors and outcome of lacunar (LAC) and non-lacunar (non-LAC) strokes from the prospective hospital based stroke registry at Colombo South Teaching Hospital from 1st March 2012 to 30th June 2013. Data on admission, discharge and at 28 days after discharge were analysed. There were 229 ischaemic stroke (IS) patients. Average age was 65.7 years (SD 12.2, range 34-94) and 116 (50.7%) were males. LAC (n=130, 56.8%) were common than non-LAC (n=99, 43.2%). There were 75 (64.7%) males and 55 (48.7%) females in the LAC group (adjusted OR 2.1, 95% CI 1.08-4.29). Atrial fibrillation was less frequent among LAC stroke (OR 0.3, 95% CI 0.09-0.99). Hypertension, diabetes, smoking, dyslipidaemia did not differ in the two groups. Lower NIHSS (5.34 Vs 6.6, p= 0.053), higher GCS (14.7 Vs 13.3, p=0.001) were seen in LAC. Disability (MRS, Barthel index) on discharge, at 28 days and mortality during hospital stay and within 28 days was lower in the LAC group (p <0.001).
本研究比较了2012年3月1日至2013年6月30日期间,科伦坡南部教学医院基于前瞻性医院卒中登记系统的腔隙性(LAC)和非腔隙性(非LAC)卒中的人口统计学、危险因素及预后。分析了入院时、出院时及出院后28天的数据。共有229例缺血性卒中(IS)患者。平均年龄为65.7岁(标准差12.2,范围34 - 94岁),男性116例(50.7%)。LAC组(n = 130,56.8%)比非LAC组(n = 99,43.2%)更常见。LAC组男性75例(64.7%),女性55例(48.7%)(校正比值比2.1,95%置信区间1.08 - 4.29)。房颤在LAC卒中中较少见(比值比0.3,95%置信区间0.09 - 0.99)。高血压、糖尿病、吸烟、血脂异常在两组中无差异。LAC组NIHSS评分较低(5.34对6.6,p = 0.053),GCS评分较高(14.7对13.3,p = 0.001)。LAC组出院时、28天时的残疾情况(改良Rankin量表、Barthel指数)以及住院期间和28天内的死亡率较低(p <0.001)。