Lacunar infarcts: Functional and cognitive outcomes at five years in relation to MRI findings
Lacunar infarcts: Functional and cognitive outcomes at five years in relation to MRI findings
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DOI：
10.1159/000086202
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发表时间：
2005-01-01
影响因子：
2.9
通讯作者：
Lindell, D
中科院分区：
文献类型：
--
作者：
Appelros, P;Samuelsson, M;Lindell, D
背景：对腔隙性脑梗塞(LIS)患者的长期随访研究很少。这项为期5年的随访研究的目的是评估与MRI结果相关的功能和认知结果。方法：对81例首次发生LI的患者进行为期5年的随访，观察其病死率、卒中复发、功能和认知结局。分别在基线和5年时进行T-2加权MRI检查。基底节病变和白质病变的存在根据欧洲特别工作组评分标准进行评分。功能结果采用牛津残疾评定量表(OHP)评定。采用简易智力状态检查(MMSE)评定认知功能。结果：5年死亡率为19%。预测死亡的因素有年龄(OR=1.07，95%CI 1.03~1.11)、缺血性心脏病(OR=2.1，95%CI 1.1~4.1)和损伤评分(OR=1.16，95%CI 1.02~1.32)。30%的患者中风复发。糖尿病(OR=1.7，95%CI 1.2~7.4)和脑白质病变数量(OR=1.7，95%CI 1.2~2.7)是卒中复发的预测因素。36%的患者有功能依赖(定义为OHP和GT；2)。功能依赖的预测因素为功能障碍评分(OR=1.71，95%CI为1.12~2.59)、MMSE(OR=0.55，95%CI为0.33~0.91)和卒中复发(OR=84，95%CI为9.4~745)。16%的患者有认知障碍(定义为MMSE
Background: There are few long-term follow-up studies of patients with lacunar infarcts (LIs). The purpose of this 5-year follow-up study was to assess functional and cognitive outcome in relation to MRI findings. Methods: 81 patients with a first-ever LI were followed for 5 years with respect to mortality, stroke recurrence, functional and cognitive outcome. T-2-weighted MRI was performed at baseline and at 5 years. The presence of basal ganglia lesions and white matter lesions was scored according to the European Task Force rating scale. Functional outcome was assessed with the Oxford Handicap Scale (OHP). Cognition was assessed with the Mini Mental State Examination (MMSE). Results: The 5-year mortality was 19%. Predictors for death were age (OR = 1.07, 95% CI 1.03-1.11), ischemic heart disease (OR = 2.1, 95% CI 1.1-4.1) and impairment score (OR = 1.16, 95% CI 1.02-1.32). 30% of the patients had a recurrent stroke. Predictors for recurrent stroke were diabetes mellitus (OR = 1.7, 95% CI 1.2-7.4) and amount of white matter lesions (OR = 1.7, 95% CI 1.2-2.7). 36% of the patients were functionally dependent (defined as OHP >2). Predictors for functional dependency were impairment score (OR = 1.71, 95% CI 1.12-2.59), MMSE (OR = 0.55, 95% CI 0.33-0.91) and stroke recurrence (OR = 84, 95% CI 9.4-745). 16% of the patients had cognitive impairment (defined as MMSE