Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Brain Behav. 2021 Aug;11(8):e2224. doi: 10.1002/brb3.2224. Epub 2021 Jun 14.
Few studies have compared the etiology and clinical features between pure lateral medullary infarction (LMI) and pure medial medullary infarction (MMI).
All patients included were hospitalized at The First Affiliated Hospital and The Second Affiliated Hospital of Wenzhou Medical University from January 2015 to July 2020. Their risk factors, clinical manifestation, stroke mechanisms and short-term prognosis were analyzed retrospectively.
Among the 387 patients enrolled, 266 (68.7%) had LMI, 109 (28.2%) had MMI, and 12 (3.1%) (nine men and three women) had LMI plus MMI. We analyzed the 375 patients of LMI and MMI. The average ages of LMI and MMI were 59.4 years and 62.69 years, respectively. Univariate analysis and multivariable logistic regression was used to investigate the existing risk factors of MMI relative to LMI. Prior infarction, poor glycemic control, and atherosclerosis were more frequently associated with MMI than with LMI. The clinical manifestation was significantly different between LMI and MMI. We used modified Rankin Scale (mRS) score as the short-term prognostic evaluation criteria, and MMI appeared worse than LMI.
This study reveals that: (1) patients with MMI are older than those with LMI; (2) prior infarction, poor glycemic control, and atherosclerosis are independent risk factors of MMI than that of LMI; (3) the clinical manifestations of LMI and MMI are heterogeneous; (4) short-term prognosis of MMI is worse than LMI.
很少有研究比较单纯延髓外侧梗死(LMI)和单纯延髓内侧梗死(MMI)的病因和临床特征。
回顾性分析 2015 年 1 月至 2020 年 7 月在温州医科大学附属第一医院和第二医院住院的所有患者的危险因素、临床表现、发病机制和短期预后。
在纳入的 387 例患者中,266 例(68.7%)为 LMI,109 例(28.2%)为 MMI,12 例(3.1%)(9 男 3 女)为 LMI+MMI。我们分析了 375 例 LMI 和 MMI 患者。LMI 和 MMI 的平均年龄分别为 59.4 岁和 62.69 岁。单因素分析和多变量逻辑回归用于研究与 LMI 相比,MMI 存在的现有危险因素。与 LMI 相比,既往梗死、血糖控制不佳和动脉粥样硬化与 MMI 更相关。LMI 和 MMI 的临床表现有显著差异。我们使用改良 Rankin 量表(mRS)评分作为短期预后评估标准,发现 MMI 比 LMI 差。
本研究表明:(1)MMI 患者比 LMI 患者年龄大;(2)既往梗死、血糖控制不佳和动脉粥样硬化是 MMI 的独立危险因素,而非 LMI;(3)LMI 和 MMI 的临床表现不同;(4)MMI 的短期预后比 LMI 差。