Department of Neurology, First Affiliated Hospital of Soochow University, No. 899, Pinghai Road, Suzhou, 215006, Jiangsu, China.
Department of Biostatistics, School of Public Health, Fudan University, No. 130 Dongan Road, Shanghai, 200032, China.
BMC Neurol. 2022 Jan 3;22(1):1. doi: 10.1186/s12883-021-02518-9.
This study was performed to identify the association between the total magnetic resonance imaging burden of small vessel disease and the occurrence of post-stroke dysphagia in patients with a single recent small subcortical infarct (RSSI).
We retrospectively identified all patients with a magnetic resonance imaging-confirmed single RSSI. The water-swallowing test and volume-viscosity swallow test were performed within the first 24 h following admission to assess swallowing. Demographic and clinical data were extracted from our stroke database. Based on brain magnetic resonance imaging, we independently rated the presence of cerebral microbleeds, lacunes, white matter hyperintensities and enlarged perivascular spaces. The presence of each small vessel disease feature was summed to determine the total small vessel disease burden, ranging from 0 to 4.
In total, 308 patients with a single RSSI were enrolled. Overall, 54 (17.5%) were diagnosed with post-stroke dysphagia. The risk factors related to post-stroke dysphagia included the following: older age, higher National Institute of Health Stroke Scale scores, higher C-reactive protein level and higher fibrinogen level. Based on multiple logistic regression, National Institute of Health Stroke Scale scores and total small vessel disease burden were independent risk factors of post-stroke dysphagia in patients with a single RSSI, after adjusting for age, gender, history of hypertension, C-reactive protein level and fibrinogen level.
Dysphagia in patients with a single RSSI was associated with a more severe total small vessel disease burden as reflected by MRI. Total MRI of cerebral small vessel disease burden may predict dysphagia in these patients. Furthermore, more severe total small vessel disease burden was associated with systemic inflammation.
本研究旨在确定小血管疾病的总磁共振成像负担与单一近期皮质下小梗死（RSSI）患者卒中后吞咽困难的发生之间的关联。
我们回顾性地确定了所有经磁共振成像证实的单一 RSSI 患者。在入院后 24 小时内进行饮水试验和容量粘度吞咽试验以评估吞咽功能。从我们的卒中数据库中提取人口统计学和临床数据。基于脑部磁共振成像，我们独立评估了脑微出血、腔隙、脑白质高信号和扩大的血管周围间隙的存在情况。将每种小血管疾病特征的存在相加，以确定总小血管疾病负担，范围为 0 至 4。
共纳入 308 例单一 RSSI 患者。总体而言，54 例（17.5%）被诊断为卒中后吞咽困难。与卒中后吞咽困难相关的危险因素包括年龄较大、国立卫生研究院卒中量表评分较高、C 反应蛋白水平和纤维蛋白原水平较高。基于多因素逻辑回归分析，在调整年龄、性别、高血压病史、C 反应蛋白水平和纤维蛋白原水平后，国立卫生研究院卒中量表评分和总小血管疾病负担是单一 RSSI 患者卒中后吞咽困难的独立危险因素。
RSSI 患者的吞咽困难与 MRI 反映的更严重的总小血管疾病负担有关。脑小血管疾病的总 MRI 负担可能预测这些患者的吞咽困难。此外，更严重的总小血管疾病负担与全身炎症有关。
