评估出血转变和脑之间的相互作用,以评估缺血性中风后的功能结果
Amrit Avula1, Quoc Bui1, Atul Kumar1
1Department of Neurology, Washington University School of Medicine, 660 S Euclid Avenue, Campus Box 8111, St. Louis, MO, USA.
概括
大多数缺血性中风后的出血转化 (HT) 病例也涉及脑 (CED). 这种重叠,在严重的中风中见到,使功能结果恶化,主要是由于胀的严重程度增加.
科学领域:
- 神经学 神经学
- 脑卒中研究 脑卒中研究
- 医疗成像医学成像
背景情况:
- 流血转变 (HT) 和大脑 (CED) 是常见的缺血性中风后并发症.
- 对于HT和CED对中风结果的重叠和综合影响尚不清楚.
研究的目的:
- 调查缺血性中风患者同时出现HT和CED (CED/HT) 的频率和预测因素.
- 为了确定CED/HT重叠是否影响功能结果,而不是单独影响任何并发症.
主要方法:
- 892名缺血性中风患者的前性研究,随访CT成像.
- 大脑水量化为半球CSF比率 (<0.90值);HT单独评估.
- 用修改的兰金尺度 (mRS) 测量3个月后的功能结果.
主要成果:
- 31%的患者患有HT;其中85%的患者也患有CED (CED/HT重叠).
- 在CED/HT组,基线NIHSS得分和心脏病发作量较高.
- 与单独使用CED (mRS 2) 或单独使用HT (mRS 1) 相比,CED/HT与更糟糕的功能结果相关 (中位数mRS 3).
- 重叠独立地预测了更糟糕的结果,但这种关联是由的严重程度驱动的.
结论:
- 大多数患有HT的中风患者也表现出可测量的CED.
- 共同发生的CED/HT与更严重的中风和更糟糕的功能结果有关.
- 在CED/HT病例中对结果的负面影响主要归因于脑的严重程度.
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