李振东，黄海威，苏镇培，黄如训.急性脑梗死神经功能缺损和3个月结局的牛津郡社区卒中项目分型评估[J].中华物理医学与康复杂志,2004,(9):
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| 急性脑梗死神经功能缺损和3个月结局的牛津郡社区卒中项目分型评估 |
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| DOI： |
| 中文关键词: 脑梗死 分型 神经功能缺损 结局 |
| 英文关键词: Cerebral infarction Classification Neurological impairment Outcome |
| 基金项目:广东省科委攻关基金资助项目（No.99MO4611G） |
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| 中文摘要: |
| 目的分型观察急性脑梗死患者神经功能缺损和3个月结局的差异。 方法前瞻性连续收集首次发病的脑梗死患者146例，分4个牛津郡社区卒中项目（OCSP）亚型比较急性期神经功能缺损评分、3个月的病死率、复发率和日常生活活动（ADL）能力评分。 结果神经功能缺损评分依次为全前循环梗死（TACI）＞部分前循环梗死（PACI）＞后循环梗死（POCI）＞腔隙性梗死（LACI），TACI与另3个亚型之间，PACI与POCI、LACI之间的差异有极显著性意义（P＜0.0005）。TACI的病死率为42%，PACI为7.6%，LACI为2%，POCI为0，差异有极显著性意义（P＜0.0005）。LACI的复发率为2%，PACI为1.5%，TACI和POCI无复发，差异无显著性意义（P>0.05）。存活者中，TACI 3个月的ADL为重度依赖，另3个亚型均为轻度依赖，差异有极显著性意义（P＜0.0005）。结论OCSP分型可以评价脑梗死的急性神经功能缺损和3个月结局的差异。 |
| 英文摘要: |
| Objective To observe difference among the different types of ischemic stroke patients as classified by the Oxfordshire Community Stroke Project (OCSP) classification, in terms of acute neurologic impairment and 3 month outcome after onset of cerebral infarction. MethodsOne hundred and forty-six consecutive admission of patients with first-ever acute cerebral infarction(onset time 30min～15d) were prospectively identified and classified as 4 OCSP subtypes to compare acute neurologic impairment score and 3 months fatality rate, recurrence rate and score of activities of daily living (ADL). ResultsThe level of neurologic impairment was TACI＞PACI＞POCI＞LACI. The statistical difference of neurologic impairment between TACI and other 3 subtypes and that between PACI and POCI or LACI was significant(P＜0.0005), but no statistically significant difference between LACI and POCI was revealed. Fatality rate of TACI was 42% (8/19), without recurrence stroke; the fatality rate of PACI was 7.6%(5/66), and its recurrence rate was 1.5% (1/66); all the LACI patients survived in acute period, but one patient recurred massive cerebral infarction at 50 days after onset, and died 2 days after recurrence.Both fatality rate and recurrence rate of LACI were 2% (1/45). None of the 16 POCI patients died and recurred. The fatality rate among the 4 subtypes was significantly different(P＜0.0005). However, the statistical difference among their recurrence rate was not significant. Among all survivors, the 3 month ADL of TACI was critical dependence, while that of other subtypes was light dependence(P＜0.0005). However, Barthel index of LACI was the highest, PACI's was smaller. ConclusionThe OCSP classification can be used to evaluate difference of acute neurologic impairment and 3-month outcome of patients with cerebral infarction. |
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