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急性孤立性脑桥梗死无任何病因性动脉狭窄患者早期神经功能恶化的危险因素。

Risk factors for early neurological deterioration in acute isolated pontine infarction without any causative artery stenosis.

机构信息

Department of Neurology, Chengdu Second People's Hospital, Chengdu, Sichuan, 610011, People's Republic of China.

Department of Neurology, Chengdu Qingbaijiang District People's Hospital, Chengdu, Sichuan, 610300, People's Republic of China.

出版信息

BMC Neurol. 2022 Sep 3;22(1):332. doi: 10.1186/s12883-022-02861-5.

Abstract

BACKGROUND

This study aimed to investigate the risk predictors for early neurological deterioration (END) in isolated acute pontine infarction without any causative artery stenosis.

METHODS

In this retrospective study, patients with isolated acute pontine infarction within 72 h of symptom onset were enrolled between October 2017 and December 2021. END was defined as an increase in the National Institutes of Health Stroke Scale (NIHSS) score ≥ 2 points within the first week postadmission. Patients were divided into the END and the non-END groups. Multiple logistic regression analysis was used to evaluate independent predictors of END in patients with isolated acute pontine infarction.

RESULTS

A total of 153 patients were included in the final study (62 females; mean age, 67.27 ± 11.35 years), of whom 28.7% (47 of 153) experienced END. Multiple logistic regression analyses showed that infarct volume (adjusted odds ratio [aOR], 1.003; 95% CI, 1.001-1.005; P = 0.002) and basilar artery branch disease  (aOR, 3.388; 95% CI, 1.102-10.417; P = 0.033) were associated with END. The combined ROC analysis of the infarct volume and basilar artery branch disease for predicting END showed that the sensitivity and specificity were 80.9% and 72.6%, respectively.

CONCLUSION

Basilar artery branch disease and infarct volume were associated with END in acute isolated pontine infarction and may be useful prognostic factors for neurological progression.

摘要

背景

本研究旨在探讨无任何责任动脉狭窄的孤立性急性脑桥梗死患者发生早期神经功能恶化(END)的风险预测因素。

方法

在这项回顾性研究中,纳入了 2017 年 10 月至 2021 年 12 月发病 72 小时内的孤立性急性脑桥梗死患者。END 定义为入院后第一周内 NIHSS 评分增加≥2 分。将患者分为 END 组和非 END 组。采用多因素 logistic 回归分析评估孤立性急性脑桥梗死患者 END 的独立预测因素。

结果

最终纳入了 153 例患者(女性 62 例;平均年龄 67.27±11.35 岁),其中 28.7%(47 例)发生了 END。多因素 logistic 回归分析显示,梗死体积(校正比值比[aOR],1.003;95%可信区间[CI],1.001-1.005;P=0.002)和基底动脉分支病变(aOR,3.388;95%CI,1.102-10.417;P=0.033)与 END 相关。梗死体积和基底动脉分支病变联合预测 END 的 ROC 分析显示,敏感性和特异性分别为 80.9%和 72.6%。

结论

基底动脉分支病变和梗死体积与急性孤立性脑桥梗死的 END 相关,可能是神经功能恶化的有用预后因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6be5/9440546/135d6f0101c4/12883_2022_2861_Fig1_HTML.jpg

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