关键词: 腔隙性脑梗死; 危险因素; 脑缺血耐受

Abstract:

Objective To investigate the related factors of early neurological deterioration (END) in patients with unilateral isolated basal ganglia lacunar cerebral infarction and the related mechanism of brain ischemic tolerance (BIT) and END. Methods Retrospective analysis were made upon clinical data of 167 patients who were diagnosed with unilateral isolated basal ganglia lacunar cerebral infarction confirmed by magnetic resonance imaging (MRI) excluding artery stenosis diagnosed. According to the score of National Institutes of Health Stroke Scale (NIHSS) of the stroke within 1 week, 167 patients were divided into two groups: positive END and negative END. Multivariate logistic regression analysis was associated to analyze factors related to the early neurologic deterioration of cerebral infarction. Results Among 167 patients, 42 (25.15%) patients suffered END and 125 patients didn’t have END. Multiple factor analysis indicated that lesions located in the internal capsule hind legs radial posterior lateral ventricle were independent risk factors for END and there were significant difference between two groups (P <0.01). The age of onset, history of cerebral infarction, history of diabetes, systolic

blood pressure at admission and lesions of cerebral white matter were associated with END, which had significant differences (P <0.05). Single factor and multi-factors analysis of with or without diabetes and difference lesion location at different layer and inter-layers showed that with or without diabetes and difference lesion location didn’t affect the association between age, history of stroke, white matter and positive ENT. END correlates with previous history of stroke, pathological changes of white matter, and age of onset, which had significant difference (P <0.05). Conclusion END in patients with unilateral isolated basal ganglia lacunar cerebral infarction is closely related to the lesion, other related factors such as lesions of cerebral white matter, history of cerebral infarction, history of diabetes and age, etc. Age of 65 years old and above, systolic hypertension, history of stroke, and lesions cerebral white matter are protective factors for positive END. Brain ischemia intolerance is the main mechanism for END.

Key words: Lacunar infarction; Risk factor; Brain ischemic tolerance