Aphasia during the acute phase in ischemic stroke
Aphasia during the acute phase in ischemic stroke
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DOI：
10.1159/000118376
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发表时间：
2008-01-01
影响因子：
2.9
通讯作者：
Uchino, M.
中科院分区：
文献类型：
--
作者：
Inatomi, Y.;Yonehara, T.;Uchino, M.
目的：探讨急性缺血性卒中失语及早期改善的发生率、临床特点、转归及相关因素。方法：对855例发病后48h内入院且入院时未昏迷的急性缺血性卒中患者进行连续研究。在入院时(第0天)和第10天进行失语评估。我们检查失语症的发生率、严重程度和亚型，并比较入院时有失语和无失语的患者以及第10天有和没有早期改善的患者的临床背景。此外，我们还调查了与入院时失语的存在和早期改善相关的独立因素。结果：855例患者中，130例(15.2%)入院时有失语症。美国国立卫生研究院卒中评分(NIHSS)(OR1.21；95%可信区间1.17-1.26)是影响患者入院时出现失语症的重要独立因素。在121名在第10天仍存活的失语症患者中，56人(46.3%)出现早期改善。高胆固醇血症病史(OR 3.27；95%CI 1.14-9.39)是急性期失语症早期改善的显著独立因素，入院时NIHSS(OR 0.95；95%CI 0.90-0.99)略显着。结论：在缺血性卒中发病后的头几天内，很难预测失语症的预后。版权所有(C)2008 S.Karger AG，巴塞尔。
Objectives: We investigated the incidence, clinical characteristics, outcome and factors associated with aphasia and early improvement in acute ischemic stroke. Methods: We consecutively studied 855 patients with acute ischemic stroke who were admitted to our hospital within 48 h after onset and who were not comatose on admission. Assessment of aphasia was performed on admission (day 0) and day 10. We examined the incidence, severity, and subtypes of aphasia, and compared the clinical background of patients with and without aphasia on admission, and also those with and without early improvement by day 10. In addition, we investigated the independent factors associated with the presence of aphasia on admission and with early improvement. Results: Of the 855 patients, 130 (15.2%) had aphasia on admission. The National Institutes of Health Stroke Scale (NIHSS) on admission (OR 1.21; 95% CI 1.17-1.26) was a significant and independent factor associated with the presence of aphasia on admission. Early improvement was seen in 56 of 121 aphasic patients (46.3%) who were still alive on day 10. A history of hypercholesterolemia (OR 3.27; 95% CI 1.14-9.39) was a significant and independent factor associated with early improvement in aphasia during the acute phase and NIHSS on admission (OR 0.95; 95% CI 0.90-0.99) was marginally significant. Conclusion: It is difficult to predict the outcome of aphasia within the first few days after the onset of ischemic stroke. Copyright (C) 2008 S. Karger AG, Basel.