| Objective To explore the influence of the vascular risk factors and the location of infarcts on the short-term prognosis of acute pontine infarction.Methods A retrospective analysis of the clinical outcomes of 85 patients with acute pontine infarction who were admitted to the Department of Neurology of The Eighth People’s Hospital of Hefei from May 2016 to December 2018,and 26 cases in the Department of Neurology of the First Affiliated Hospital of Anhui Medical University from January 2017 to December 2018.All patients recorded their contact information,gender,age,smoking history,drinking history,and the medical history of hypertension,diabetes,coronary heart disease,and stroke in detail;all patients were given a head MRI + DWI examination within one week after admission;all patients were enrolled in The National Institutes of Health Stroke Rating Scale(NIHSS)and ADL scale to evaluate neurological deficits and self-care ability at admission,discharge,and 90 days after the onset of disease;All selected patients were followed up with Outpatient or telephone after 90 days of onset and their prognosis were scored and record by the modified Rankin Score Scale.According to the score results,they were divided into the good prognosis group(m RS 0-2 points)and poor prognosis group(m RS 3-5 points).The vascular risk factors,infarct location,NIHSS,and ADL were compared between the two groups.The effects of risk factorsand infarct location on the short-term prognosis of pontine infarction were analyzed.Results According to the m RS,111 selected patients were divided into the good prognosis group(n=76)and the poor prognosis group(n=35).(1)The univariate analysis of the two groups showed statistically significant differences(P <0.05)in the history of diabetes,stroke,Hb A1 c levels,and the paitents combined the history of hypertension,diabetes and stroke.There was not statistically difference in the gender,age,systolic blood pressure,diastolic blood pressure,pulse pressure difference,homocysteine(Hcy),total cholesterol(TCH),low density lipoprotein(LDL-C),smoking history,coronary heart disease history,hypertension history between the two groups(P(29)0.05).(2)There was no significant difference in the NIHSS score and ADL score between the two groups of patients at admission(P(29)0.05),and there were statistically significant differences(P <0.05)in the NIHSS scale and ADL score between the two groups at discharge and at 90-day follow-up.(3)According to the blood supply and vascular distribution of the pontine,the pontine is divided into four areas,namely the anterior medial area(lateral central arterial blood supply),anterior lateral area(short arterial blood supply),and lateral area(long arterial blood supply).Among the 25 patients whose infarcts location were in anteromedil region,23 cases(30.26%)had a good prognosis and 2 cases(5.71%)had a bad prognosis.The difference between the two groups were statistically significant.There was no significant difference in the location of infarct in other regions(P(29)0.05).(4)The univariate analysis showed a significant difference(P <0.05)in the history of diabetes,stroke,and infarcts located in the anterior medial area.Further multivariate logistic regression analysis showed that The history of diabetes mellitus and stroke were independent risk factors for pontine infarction and the location of infarction in the anterior medial area was independently related to pontine infarction.Conclusions(1)Patients with pontine infarction with a history of diabetes,stroke,and high Hb A1 c levels have a worse prognosis.(2)The anterior medial area is the most common site of pontine infarction,and the prognosis is relatively good in this area. |
