| Objective:To analyze the clinical data of patients with acute brainstem infarction and explore the relationship between DWI score and severity of clinical symptoms and its clinical significance.Methods:A retrospective analysis was made of 269 patients with acute brainstem infarction hospitalized in the Department of Neurology,Second Hospital of Jilin University from August 2017 to September 2018.The data of these patients were collected,including past stroke history,hypertension,diabetes,smoking history,drinking history,routine blood test indicators,head magnetic resonance diffusion examination and the degree of neurological deficit at admission.Brainstem infarction was divided into subgroups according to different parts of the brain stem,including midbrain,pons,medulla oblongata and mixed parts of the infarction;DWI was scored according to diffusion weighted imaging of the head;e-NIHSS was scored according to the severity of symptoms and the degree of neurological deficit at admission.To summarize the clinical data characteristics of 269 patients with brain stem infarction;To analyze the differences of risk factors of brain stem infarction in different parts;the correlation between brain stem DWI score and severity of symptoms;the consistency of brain stem DWI score with symptom degree and related factors.The data was statistically processed using SPSS 19.0 software,and the normality of the data was tested by Kolmogorov-Smirnov.In the measurement data,the normal distribution was expressed by mean(~c±s).T test was used for comparison between two groups,and variance analysis was used for comparison between multiple groups;M(P25,P75)for non-normal distribution was used for comparison between two groups,Mann-Whitney U test was used for comparison between two groups,and Kruskal-Wallis test was used for comparison between multiple groups.The counting data were expressed by frequency(%)and checked by chi-square test.Spearman grade correlation was used for correlation test.The difference was statistically significant at P<0.05,and the difference was statistically significant at P<0.01.Results:1.A total of 269 patients were included in the analysis,The mean age was62.21±11.12 years old,176 males(65.4%)and 93 females(34.6%).There were 79stroke cases(29.4%),99 smoking cases(36.8%),75 drinking cases(27.9%),119diabetes cases(44.2%)and 186 hypertension cases(69.1%).There were 55 cases(20.4%)of hypersensitivity C-reactive protein,55 cases(20.4%)of hyperuricemia,20cases(7.4%)of fibrinogen degradation products,184 cases(68.0%)of hyperlipidemia and 120 cases(44.6%)of hyperhomocysteinemia.There were 25 cases of cerebral infarction(9.3%),177 cases of pontine infarction(65.8%),52 cases of medullary infarction(19.3%)and 15 cases of mixed site infarction(5.6%).The median of DWI score in patients with brainstem infarction was 2,and the median of e-NIHSS score was 4.2.Comparisons of infarction in different parts of brainstem:There was no significant difference in age and sex among subgroups(P>0.05),and male patients were more than female patients in each group;there was no significant difference in stroke history,hypertension,diabetes mellitus,smoking history and drinking history among subgroups(P>0.05),and the proportion of hypertensive patients in each group was higher than that of non-hypertensive patients.There was no statistical difference in symptoms,Hcy,hs-CRP and uric acid among the subgroups(P>0.05);FDP had statistical difference among the subgroups(P<0.05),and the level of FDP in the mixed part was higher than that in the single part;the severity of symptoms had statistical difference among the subgroups(P<0.05);the DWI score had statistical difference among the subgroups(P<0.05).3.The upper part of the pons has a higher e-NIHSS score than the middle and lower infarction.4.The correlation coefficient between brainstem DWI score and e-NIHSS score was 0.258,P<0.05.5.The hs-CRP level had a significant effect on the DWI score and the symptom matching group and the DWI score and the symptom inconsistency group(P<0.05).Gender,age,symptom onset to DWI time,past stroke history,smoking history,drinking history,Hypertension,diabetes,hyperlipidemia,Hcy,FDP,uric acid were not statistically different between the two groups(P>0.05).Conclusion:1.In patients with acute brain stem infarction,the DWI score is weakly correlated with the severity of symptoms.The DWI score does not represent the severity of the symptoms to some extent.2.In acute brain stem infarction,there were no significant differences in risk factors between patients with brain stem infarction in different parts;the most infarction occurred in the pons,and the infarction was the most severe in the upper part of the pons. |
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