应用rLMC评分预测急性大脑中动脉M1段或颈内动脉闭塞卒中患者临床预后

发布时间：2018-04-18 20:25

本文选题：侧支循环 + rLMC评分　；参考：《中风与神经疾病杂志》2016年08期

【摘要】：目的通过基于CTA评价的区域软脑膜评分(rLMC)评估大脑中动脉M1段或颈内动脉闭塞缺血性卒中患者的二级脑侧支循环开放水平,研究其与患者临床表现及中期临床预后的相关性。方法回顾性分析90例大脑中动脉M1段或颈内动脉闭塞急性缺血性卒中患者的临床资料,均在发病9 h内行CTA检查,依据rLMC评分分组,a组:rLMC评分0~10;b组:11~16;c组:17~20,在180 d mRS≤2认定为临床结局良好。研究卒中患者软脑膜侧支循环代偿与临床预后的相关性。结果分析纳入90例患者,拥有差的rLMC评分,共24例,约占26.7%,拥有中等的rLMC评分,共40例,约占44.4%;拥有良好的rLMC评分,共26例,约占28.9%。同时发现侧支循环良好组的早期神经功能缺损程度更轻,早期神经功能恢复及中期临床预后更好,差异均有统计学意义(P0.01)。结论对于急性大脑中动脉M1段或颈内动脉闭塞缺血性卒中患者基于CTA的rLMC评分能够有效预测早期神经功能缺损的改善及中期临床预后。
[Abstract]:Objective through regional evaluation based on CTA score piamater (rLMC) evaluation of M1 artery or internal carotid artery occlusion of the middle cerebral ischemic stroke patients two cerebral collateralcirculation level, and to study its clinical manifestations and mid-term clinical prognosis. Methods a retrospective analysis of the clinical data of 90 cases of M1 segment of internal carotid artery occlusion of the middle cerebral artery or in patients with acute ischemic stroke, the incidence of 9 h were underwent CTA examination, according to the rLMC scores, a scores of rLMC group: 0~10; group B: 11~16; group C: 17~20, 180 d mRS = 2, identified as good clinical outcomes. Study on the correlation between stroke patients with leptomeningeal collateral circulation and clinical prognosis. The analysis included 90 patients with poor rLMC score, a total of 24 cases, accounting for about 26.7%, with moderate rLMC score, a total of 40 cases, accounting for about 44.4%; have a good rLMC score, a total of 26 cases, accounting for about 28.9%. and found good collateral circulation Early neurological deficits were more light, early neurological recovery and middle term clinical prognosis better, the differences were statistically significant (P0.01). Conclusion the M1 segment artery or internal carotid artery occlusion in acute cerebral ischemic stroke patients based on the CTA rLMC score can effectively predict early neurological function improvement and mid-term clinical prognosis.

【作者单位】：大连市第三人民医院神经内科;大连市中心医院神经内科;
【基金】：大连市卫计委科研项目(No.2014-43)
【分类号】：R743.3

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