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复发性脑桥梗死的部位及机制:一项基于医院的随访研究

Site and Mechanism of Recurrent Pontine Infarction: A Hospital-Based Follow-Up Study.

作者信息

Wu Li, Li Youfu, Ye Zeming, Liu Dezhi, Dai Zheng, Zhu Juehua, Chen Hongbing, Li Chenghao, Lie Chaowei, Jiang Yongjun

机构信息

Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, 250 Changgang East Road, Guangzhou 510260, China.

Department of Neurology, Guangzhou Panyu District Hexian Memorial Hospital, 2 Qinghe East Road, Guangzhou 511400, China.

出版信息

Brain Sci. 2022 Apr 20;12(5):520. doi: 10.3390/brainsci12050520.

Abstract

Although pontine infarction is the most common subtype of posterior circulation stroke, there has been little research focusing on recurrent pontine infarction. Our study aimed to investigate the factors associated with site and mechanism of recurrent pontine infarction. Patients with acute isolated pontine infarction were enrolled and followed up for one year. Lesion topography was determined by diffusion-weighted imaging. Mechanisms were determined based on lesion topography and other vascular, cardiologic and laboratory results. A total of 562 patients with pontine infarction were included, with 67 patients experiencing recurrence during the follow-up period. Forty-one recurrences occurred at the same site as index pontine infarction (41/67, 61.2%). Results indicated that the mechanism of index pontine infarction was significantly associated with the recurrent sites ( = 0.041, OR 2.938, 95% CI 1.044-8.268), and also with the mechanisms of recurrence ( = 0.004, OR 6.056, 95% CI 1.774-20.679). Branch atheromatous disease-induced index pontine infarction was likely to recur at the same site and with the same mechanism. Moreover, if recurrence occurred at the same site, the mechanism was probably the same as that of the index stroke ( = 0.000). Our study may help physicians treat patients with pontine infarction by predicting the site and mechanism of recurrence.

摘要

尽管脑桥梗死是后循环卒中最常见的亚型,但针对复发性脑桥梗死的研究却很少。我们的研究旨在探讨与复发性脑桥梗死的部位和机制相关的因素。纳入急性孤立性脑桥梗死患者并随访一年。通过弥散加权成像确定病变部位。根据病变部位以及其他血管、心脏和实验室检查结果确定发病机制。共纳入562例脑桥梗死患者,其中67例在随访期间出现复发。41例复发发生在与初次脑桥梗死相同的部位(41/67,61.2%)。结果表明,初次脑桥梗死的发病机制与复发部位显著相关(P = 0.041,OR 2.938,95%CI 1.044 - 8.268),也与复发机制相关(P = 0.004,OR 6.056,95%CI 1.774 - 20.679)。分支动脉粥样硬化性疾病所致的初次脑桥梗死很可能在同一部位以相同机制复发。此外,如果在同一部位复发,其机制可能与初次卒中相同(P = 0.000)。我们的研究可能有助于医生通过预测复发部位和机制来治疗脑桥梗死患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/89af/9138740/879bee742445/brainsci-12-00520-g001.jpg

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