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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Leukoaraiosis correlates with the neurologic deterioration after small subcortical infarction
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Leukoaraiosis correlates with the neurologic deterioration after small subcortical infarction

机译：小骨皮质下梗死后白细胞疏松症与神经系统恶化相关

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Background Patients of small subcortical infarction sometimes have neurologic deterioration (ND), with the risk factors and specific pathogenesis unclear. Small subcortical infarction is often accompanied by other phenotypes of small vessel disease such as leukoaraiosis, which indicates the white matter hyperintensities in the deep or periventricular areas on the fluid-attenuated inversion recovery series of magnetic resonance images and was proved to be associated with stroke in various aspects. In this study, we intended to investigate whether leukoaraiosis was associated with ND after small subcortical infarction, and explore other possible risk factors of ND. Methods Patients with single acute subcortical infarction (<1.5 cm in diameter) were recruited consecutively and evaluated everyday. ND was defined as worsening by 2 points or more in the National Institutes Health Stroke Scale (NIHSS) score, or by 1 point or more in the NIHSS score for motor function within 1 week after stroke onset. Leukoaraiosis was rated according to the age-related white matter changes scale. Univariate and multivariate analyses were performed to identify the risk factors for ND. Results Eighty-four of 435 patients (19.31%) had ND. Univariate analysis showed that age, severity of leukoaraiosis, baseline NIHSS score, presence of diabetes, hemoglobin A1c, and total cholesterol levels were all associated with ND. Multivariate analysis further identified that the severity of leukoaraiosis especially leukoaraiosis adjacent to the index infarction, baseline NIHSS score, and diabetes were independently associated with ND. Conclusions Severity of leukoaraiosis and baseline neurologic deficits, and the presence of diabetes were all independently associated with ND after small subcortical infarction.
机译：背景小皮层下梗死的患者有时会出现神经系统恶化（ND），其危险因素和具体发病机制尚不清楚。小皮层下梗死常伴有其他小血管疾病的表型，如白细胞疏松症，这表明磁共振图像的液体衰减反转恢复系列中深部或脑室周围区域的白质过高，并被证明与脑卒中有关各方面。在这项研究中，我们打算调查小皮层下梗死后白细胞软化症是否与ND相关，并探讨其他可能的ND危险因素。方法连续招募单个急性皮层下梗死（直径<1.5 cm）的患者，并每天进行评估。 ND定义为卒中后1周内，美国国立卫生研究院健康卒中量表（NIHSS）评分恶化2分或以上，或运动功能NIHSS评分恶化1点以上。根据年龄相关的白质变化量表对白细胞疏松症进行了评分。进行单因素和多因素分析以鉴定ND的危险因素。结果435例患者中有84例（19.31％）患有ND。单因素分析显示，年龄，白细胞增多症的严重程度，基线NIHSS评分，糖尿病的存在，血红蛋白A1c和总胆固醇水平均与ND相关。多变量分析进一步确定，白细胞疏松症的严重程度，特别是与梗死指数，基线NIHSS评分和糖尿病相邻的白细胞疏松症与ND独立相关。结论小皮层下梗死后，白斑病的严重程度和基线神经功能缺损以及糖尿病的存在均与ND独立相关。

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