Department of Rehabilitation/Hanwa Memorial Hospital, Osaka, Japan.
School of Comprehensive Rehabilitation/College of Health and Human Science/Osaka Prefecture University, Osaka, Japan.
Clin Neurol Neurosurg. 2022 Jul;218:107267. doi: 10.1016/j.clineuro.2022.107267. Epub 2022 Apr 29.
Branch atheromatous disease (BAD) is often associated with corticospinal tract injury, and some patients develop early neurological deterioration (END) in the acute phase. This study investigated the progress of upper limb prognosis after BAD in the acute phases and examined the factors related to the prognosis of upper limb function.
108 subjects diagnosed with BAD were included. Then subjects were classified into two groups: those with good recovery of upper limb function and those with poor recovery of upper limb function. Univariate and multivariate analyses were performed with the objective variable being good or poor upper limb function. The following factors were used as explanatory variables: age, the volume of infarction, initial Fugl-Meyer assessment (FMA) upper limb score, and presence of END.
The univariate analysis showed significant differences in age and volume of infarction (p < 0.05). Multivariate analysis showed the following finding: age;(OR 0.977,95%CI 0.917-0.997,p = 0.0061; volume of infarction;(OR 0.645,95%CI 0.461-0.902,p = 0.0104). A significant difference was found in the age and volume of the infarct.
This study finding suggests that age and volume of infarction are associated with the prognosis of upper extremity paralysis in BAD.
分支粥样硬化病变（BAD）常与皮质脊髓束损伤相关，部分患者在急性期出现早期神经功能恶化（END）。本研究旨在探讨 BAD 急性期上肢预后的变化，并探讨与上肢功能预后相关的因素。
纳入 108 例 BAD 患者，根据上肢功能恢复情况将患者分为上肢功能恢复良好组和上肢功能恢复不良组。采用单因素和多因素分析，以上肢功能恢复良好或不良为因变量，将年龄、梗死体积、初始 Fugl-Meyer 上肢评分和 END 作为解释变量。
单因素分析显示年龄和梗死体积差异有统计学意义（p<0.05）。多因素分析显示：年龄（OR 0.977，95%CI 0.917-0.997，p=0.0061）；梗死体积（OR 0.645，95%CI 0.461-0.902，p=0.0104）。
本研究结果提示年龄和梗死体积与 BAD 患者上肢瘫痪的预后相关。
