脑梗死非溶栓治疗出血性转化的MR分型与预后相关性研究

卑贵光; 李松柏; 马 虹; 程志亮; 蒋宝国; 李 响

中国临床医学影像杂志 ›› 2011, Vol. 22 ›› Issue (8) : 533-536.

论著

脑梗死非溶栓治疗出血性转化的MR分型与预后相关性研究

卑贵光1，李松柏2，马虹1，程志亮1，蒋宝国3，李响4

作者信息 +

The correlative study between MR classification of hemorrhagic transformation of non-thrombolytic therapy brain infarction and clinical outcome

BEI Gui-guang1, LI Song-bai2, MA Hong1, CHENG Zhi-liang1, JIANG Bao-guo3, LI Xiang4

Author information +

文章历史 +

摘要

目的：①建立脑梗死非溶栓治疗出血性转化（HT）的磁共振（MR）分型方法；②验证其与预后的相关性。材料和方法：回顾性分析421例MR弥散加权（DWI）检查有高信号病灶的非溶栓治疗的急性脑梗死病例，依据自定MR分型方法对其中的31例HT进行分型，并与3个月后神经功能修订的Rankin量表（mRs）评分进行相关性研究，对伴或不伴有HT的脑梗死患者的预后相关性进行单因素分析，并进行χ2检验，两组间比较用ｔ检验。结果：421个病例中，31例（7.4%）发生HT，其中Ⅰ级10人（2.34%），Ⅱ级4人（0.95%），Ⅲ级17人（4.0%）。3个月后神经功能mRs评分，165人（39.2%）出现神经功能减退（mRs 3~5）或死亡，其中35人（8.3%）死亡；发生HT的31人中，有21人（67.7%）出现神经功能减退或死亡。Ⅱ级、Ⅲ级与预后不良明显相关。结论：7.4%非溶栓治疗的急性脑梗死病例发生HT，脑干或小脑HT、大面积梗死HT与预后不良显著相关，急性脑梗死HT的MR分型与预后有良好的相关性。

Abstract

Objective: We intend to ①establish a MR classification method of hemorrhagic transformation(HT) of brain infarction; ②investigate the correlative relation between MR classification of HT of brain infarction and clinical outcome. Then investigate the applicative value of MR classification method of brain infarction HT on assessment clinical outcome. Materials and Methods: Review 421 non-thrombolytic therapy for acute brain infarction cases, who were examined and cured in our hospital from October 2007 to November 2009. All cases had high signal on DWI images performed at 3~7 days after stroke onset. Thirty-one HT cases were classificated by our own MR classification method. The correlative relation between MR classification of HT of brain infarction and clinical outcome were investigated. Disability and function repaired were assessed after 3 months using the modified Rankin score(mRs). Outcomes in patients with and without HT were compared by χ2 test. t test was used between two groups. Results: In all 421 cases, 31 cases(7.4%) had HT, grade Ⅰ: 10 cases(2.34%), grade Ⅱ: 4 cases(0.95%), grade Ⅲ: 17 cases(4.0%). 3-month mRs: 165 cases(39.2%) had disability(mRs 3~5) or died， 35 cases（8.3%）died. In 31 HT cases, 21 cases(67.7%) had disability or died. Grade Ⅱ HT, grade Ⅲ HT had significant relationship with poor outcomes. Conclusions: 7.4% non-thrombolytic therapy for acute brain infarctions had HT, brain stem or cerebellum HT, large area HT had significant relationship with poor outcomes; MR classification method of HT of non-thrombolytic therapy for brain infarction had significant relationship with outcomes.

导出引用

卑贵光;李松柏;马虹;程志亮;蒋宝国;李响. 脑梗死非溶栓治疗出血性转化的MR分型与预后相关性研究[J]. 中国临床医学影像杂志. 2011, 22(8): 533-536

BEI Gui-guang;LI Song-bai;MA Hong;CHENG Zhi-liang;JIANG Bao-guo;LI Xiang. The correlative study between MR classification of hemorrhagic transformation of non-thrombolytic therapy brain infarction and clinical outcome[J]. Journal of China Clinic Medical Imaging. 2011, 22(8): 533-536

中图分类号： R743.33 R445.2