Duan Yaqi, Chen Fei, Lin Lang, Wei Wei, Huang Yonghua
Department of Medical Ultrasonics, General Hospital of Beijing Military Command Beijing, China.
Department of Neurology, 254 Hospital Tianjin, China.
Int J Clin Exp Med. 2015 Oct 15;8(10):19304-10. eCollection 2015.
In this study, we determine the effects of leukoaraiosis and lacunes on the clinical outcome and relative complications of acute ischemic stroke patients. From January 2007 to June 2008, 323 consecutive patients with acute brain infarction were prospectively studied. Leukoaraiosis was defined as moderate or severe white matter hyperintensities, and lacunes were counted as follows: none (0 lacune), few (1-2 lacunes), and many (≥3 lacunes). During a three-month period after the onset of stroke, patient outcomes and the incidence of complications were assessed. Backward stepwise logistic regression was used to identify the independent predictors of adverse outcome and complications after stroke. During the follow-up, 128 patients (39.63%) experienced adverse outcomes (i.e., death or disability), and 69 patients (21.36%) developed chest infections. Leukoaraiosis was an independent predictor of adverse outcome and chest infection (adverse outcome: odds ratio, 3.971, 95% confidence interval, 1.954-8.073; chest infection: odds ratio, 1.809, 95% confidence interval, 1.220-2.681), whereas no associations were observed between lacunes and adverse outcomes or complications after stroke. In conclusion, Leukoaraiosis but not lacunes was an independent predictor of adverse outcomes and chest infection in acute ischemic stroke patients. The difference between the effects of lacunes and leukoaraiosis may reflect the heterogeneity of these two primary features of small vessel diseases.
在本研究中，我们确定了脑白质疏松症和腔隙性脑梗死对急性缺血性脑卒中患者临床结局及相关并发症的影响。从2007年1月至2008年6月，对323例连续的急性脑梗死患者进行了前瞻性研究。脑白质疏松症被定义为中度或重度白质高信号，腔隙性脑梗死的计数如下：无（0个腔隙）、少（1 - 2个腔隙）和多（≥3个腔隙）。在卒中发病后的三个月内，评估患者的结局和并发症发生率。采用向后逐步逻辑回归来确定卒中后不良结局和并发症的独立预测因素。在随访期间，128例患者（39.63%）出现不良结局（即死亡或残疾），69例患者（21.36%）发生肺部感染。脑白质疏松症是不良结局和肺部感染的独立预测因素（不良结局：比值比，3.971，95%置信区间，1.954 - 8.073；肺部感染：比值比，1.809，95%置信区间，1.220 - 2.681），而未观察到腔隙性脑梗死与卒中后不良结局或并发症之间存在关联。总之，脑白质疏松症而非腔隙性脑梗死是急性缺血性脑卒中患者不良结局和肺部感染的独立预测因素。腔隙性脑梗死和脑白质疏松症作用的差异可能反映了小血管疾病这两个主要特征的异质性。
