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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Clinical Features, Risk Factors, and Early Prognosis for Wallerian Degeneration in the Descending Pyramidal Tract after Acute Cerebral Infarction
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Clinical Features, Risk Factors, and Early Prognosis for Wallerian Degeneration in the Descending Pyramidal Tract after Acute Cerebral Infarction

机译：急性脑梗死后下降金字塔底层在下降金字塔梗死中的临床特征，危险因素和早期预后

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Background: Wallerian degeneration(WD) occurs in the descending pyramidal tract (DPT) after cerebral infarction commonly, but studies of its degree evaluation, influencing factors and effects on nervous function are still limited. Objectives: The purpose of this study was to describe these findings and estimate their clinical significance. Methods: In total, 133 patients confirmed acute cerebral infarction and restricted diffusion in the DPT of the cerebral peduncle by MRI scans. These cases were retrospectively reviewed. We describe their clinical characteristics and analyze influence factors of WD, including the timespan from symptom onset to MRI and TOAST classification. Their NIHSS scores at admission and first 7 days NIHSS improvement rate after admission were also analyzed. Results: These patients were divided into three groups by timespan 14 days(n = 18). The mean WD degree (%)of these three groups was 44.41 +/- 22.51,52.35 +/- 22.61and 44.31 +/- 19.35,respectively(p = 0.122).According to the TOAST classification, the mean WD degree(%) of the cardioembolism group (n = 28, 62.80 +/- 25.12) was significantly different from both the large-artery atherosclerosis group(n = 73,45.08 +/- 20.03,p = 0.000) and the small-vessel occlusion group (n = 23,39.68 +/- 16.95,p = 0.000). The mean NIHSS score upon admission of the WD degree 50% group (n = 51,11.31 +/- 7.00)(p = 0.006). However, the mean 7 days NIHSS improvement rate(%) of the WD degree 50% group (n = 50,13.40 +/- 27.88) was not significantly different(p = 0.733). Conclusions: Early WD in ischemic stroke patients has a correlation with serious baseline functional defects. Therefore, we should give close attention to imaging change, especially in those with cardioembolism.
机译：背景：华勒氏变性（Wallerian degeneration，WD）常发生在脑梗死后的锥体下降束（Desting Pyramial tract，DPT），但对其程度评价、影响因素及对神经功能影响的研究仍很有限。目的：本研究的目的是描述这些发现并评估其临床意义。方法：共有133例患者通过MRI扫描证实急性脑梗死和脑梗DPT扩散受限。对这些病例进行回顾性分析。我们描述了他们的临床特征，并分析了WD的影响因素，包括从症状开始到MRI和TOAST分类的时间跨度。还分析了他们入院时的NIHSS评分和入院后前7天的NIHSS改善率。结果：这些患者按时间跨度14天分为三组（n=18）。这三组患者的平均WD程度（%）分别为44.41+/-22.51、52.35+/-22.61和44.31+/-19.35（p=0.122）。根据TOAST分类，心脏栓塞组（n=28,62.80+/-25.12）的平均WD程度（%）与大动脉硬化组（n=73,45.08+/-20.03，p=0.000）和小血管闭塞组（n=23,39.68+/-16.95，p=0.000）显著不同。WD学位50%组入院时的平均NIHSS评分（n=51,11.31+/-7.00）（p=0.006）。然而，WD程度50%组（n=50,13.40+/-27.88）的平均7天NIHSS改善率（%）没有显著差异（p=0.733）。结论：缺血性卒中患者早期WD与严重的基线功能缺陷相关。因此，我们应该密切关注影像学改变，尤其是那些有心脏栓塞的患者。

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