无症状性脑梗死对首发急性脑卒中患者预后的影响分析

发布时间：2018-05-17 11:38

本文选题：无症状性脑梗死 + 首发急性脑卒中　；参考：《湖南师范大学学报(医学版)》2016年06期

【摘要】：目的 :探讨无症状性脑梗死对首发急性脑卒中患者预后的影响。方法 :选择2010年6月~2012年6月在我院接受治疗的135例急性脑卒中患者,按照MRI检查是否伴有无症状脑梗死将患者分为无症状性脑梗死(SCI)组与非无症状性脑梗死(非SCI)组,其中SCI组62例,非SCI组73例,采用蒙特利尔认知评估量表(Mo CA)及简明智力状态检查量表(MMSE)分别对两组患者发生脑卒中2周及3个月进行认知功能评定,并对两组患者肢体活动能力及3年内复发率、死亡率进行统计比较。结果 :SCI组与非SCI组两周及3个月VCIND、VD比较差异具有统计学意义。脑卒中3个月后两组患者认知功能损害均有不同程度的下降,但所占比例仍较高。虽然非SCI组两周及三个月VCIND发生率较SCI组高,但SCI组两周及三个月显示出更高的VD趋势。与卒中后2周比较,非SCI组患者总体认知功能显著改善,视空间执行功能、注意力和抽象思维能力显著改善,比较差异具有统计学意义;而SCI组与两周时比较,卒中后3个月SCI组总体认知功能及视空间执行功能、注意力和抽象思维能力无显著改善,无统计学意义。SCI组不能抬起上肢、不能独立行走及3年内脑梗死复发率、3年内死亡率均显著高于非SCI组,比较差异具有统计学意义。结论 :无症状性脑梗死对首发急性脑卒中患者显示出更高的VD趋势,会进一步加重脑卒中患者认知的损害,并且具有较高的致残率、脑梗死复发率及死亡率。在临床上应重视对SCI的诊断,并使患者对SCI的危害得到充分的认识,积极的采取针对性的措施,以预防脑卒中的发生。
[Abstract]:Objective: to investigate the effect of asymptomatic cerebral infarction on the prognosis of patients with first acute stroke. Methods: 135 patients with acute cerebral apoplexy who were treated in our hospital from June 2010 to June 2012 were divided into two groups according to MRI examination: asymptomatic cerebral infarction (SCI) group and non-asymptomatic cerebral infarction (non-SCI) group. There were 62 cases in SCI group and 73 cases in non-SCI group. The cognitive function was evaluated by the Montreal Cognitive Assessment scale (MMA) and the brief Mental State examination scale (MMSE) for 2 weeks and 3 months, respectively. The limb mobility, recurrence rate and mortality rate in 3 years were compared statistically between the two groups. Results there was a significant difference in VCINDV between the two groups and the non SCI group in 2 weeks and 3 months. Three months after stroke, cognitive impairment in both groups decreased in varying degrees, but the proportion was still high. Although the incidence of VCIND in the non-SCI group was higher than that in the SCI group for two weeks and three months, the incidence of VCIND in the SCI group was higher than that in the SCI group at two weeks and three months. Compared with the two weeks after stroke, the overall cognitive function, visual space executive function, attention and abstract thinking ability were significantly improved in the non SCI group, while the difference was statistically significant in the SCI group and two weeks after stroke. 3 months after stroke, there was no significant improvement in the overall cognitive function, visual space executive function, attention and abstract thinking ability in the SCI group, and there was no statistical significance. The upper limb could not be raised in the sci group. The recurrence rate of cerebral infarction within 3 years and the death rate within 3 years were significantly higher than those in non-SCI group, and the difference was statistically significant. Conclusion: asymptomatic cerebral infarction has a higher VD trend in patients with initial acute stroke, which will further aggravate the cognitive impairment of stroke patients, and has a higher rate of disability, recurrence and mortality of cerebral infarction. We should pay more attention to the diagnosis of SCI in clinic, and make the patients fully aware of the harm of SCI, and take effective measures to prevent the occurrence of cerebral apoplexy.
【作者单位】：哈励逊国际和平医院神经内二科;
【分类号】：R743.33

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