王開+王海軍

【摘要】 目的：分析新發(fā)孤立性腦橋梗死不同的形態(tài)學部位與患者急性期發(fā)生神經功能缺損進展的相關性。方法：對2012年2月-2016年2月收治的新發(fā)孤立性腦橋梗死168例患者臨床資料進行回顧性分析，患者均經MRI確診，按患者是否出現急性期的神經功能缺損進展分成進展組和未進展組，分析兩組患者臨床特征、實驗室指標、形態(tài)學部位差別及不同的形態(tài)學部位與神經功能缺損進展相關性。結果：新發(fā)孤立性腦橋梗死168例患者中，進展組占26.8%（45/168），未進展組占73.2%（123/168）。與未進展組比較，進展組在女性患者[57.8%（26/45） vs 43.1%（53/123）， x2=5.137]、吸煙[13.3%（6/45） vs 26.8%（33/123）， x2=5.092]、住院時間[（22.9±7.1）d vs （16.9±7.3）d，t=6.137]、短期預后不良比例[77.8%（35/45） vs 33.3%（41/123）， x2=31.812]、腦橋下部梗死率[44.4%（20/45） vs 30.1%（37/123）， x2=6.038]，差異均有統(tǒng)計學意義（P<0.05）。經Logistic回歸分析提示下部梗死是該類患者急性期出現神經功能缺損進展獨立的危險因素[OR=1.953，95%CI（1.092，3.535），P=0.029]。結論：新發(fā)孤立性腦橋梗死患者形態(tài)學中下部梗死可以作為預測急性期出現神經功能缺損進展的一個指標。

【關鍵詞】 腦橋梗死； 神經功能缺損； 急性期； 彌散加權成像

Relationship between Different Topographic Location and Neurological Deterioration in Acute New Isolated Pontine Infarction/WANG Kai，WANG Hai-jun.//Medical Innovation of China，2017，14（11）：001-004

【Abstract】 Objective：To discuss the relationship between different topographic location and neurological deterioration（ND）in patients with acute new isolated pontine infarction.Method：168 patients with acute new isolated pontine infarction from February 2012 to February 2016 and identified by diffusion weighted imaging（OWI），were included for retrospective review.Patients were divided into two groups according to their clinical symptoms：the patients with ND group and thepatients without ND group.The correlations of ND with risk factors，laboratory examination results，clinical manifestations and different topographic locations were analysed by statistical tests.Rusult：Among 168 patients，26.8%（45/168）were diagnosed with ND，73.2%（123/168） were diagnosed without ND.Univariate analysis showed that there were differences in female ratio[57.8%（26/45） vs 43.1%（53/123）， x2=5.137]，smoking ratio[13.3%（6/45）vs 26.8%（33/123），x2=5.092]，mean length of hospital stay[（22.9±7.1）d vs （16.9±7.3）d，t=6.137]，ratio of worse short-term clinical outcomes[77.8%（35/45） vs 33.3%（41/123），x2=31.812] and ratio of lower pontine infarction[44.4%（20/45） vs 30.1%（37/123），

x2=6.038] between two groups （P<0.05）.Logistic regression analysis showed that lower pontine infarction was the independent risk factor of ND[OR=1.953，95%CI（1.092，3.535），P=0.029].Conclusion：Topographic location of lower pons lesions may be reliable predictor of ND in acute new isolated pontine infarction.

【Key words】 Pons infarction； Neurological deterioration； Acute stage； Diffusion weighted imaging

First-authors address：General Hospital of Fushun Mining Group，Fushun 113008，China