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目的按照牛津郡社区卒中规划(OxfordshireCommunityStrokeProject,OCSP)病因分型的构成,分析缺血性卒中住院患者不同亚型与预后的关系。方法采用前瞻性队列研究方法,连续性登记2004年1～7月入院的缺血性卒中患者,按照OCSP标准进行分型,分析OCSP各亚型与预后的关系。结果共纳入缺血性卒中患者197例。OCSP各亚型构成比为:全前循环梗死10.2%,部分前循环梗死26.9%,后循环梗死19.3%和腔隙性梗死43.6%。各型6个月末病死率比较,全前循环梗死占27.6%,腔隙性梗死占1.1%,有显著性差异(P<0.05)。各型6个月末Barthel指数评分比较,腔隙性梗死最高(45.2%),全前循环梗死最低(7.4%),有显著性差异(P<0.05)。各型6个月末复发例数均较少,结论尚待进一步验证。结论OCSP分型作为一种缺血性卒中根据临床表现分型方法,可以为缺血性卒中的预后估计提供参考依据。
Objective To analyze the relationship between different subtypes of hospitalized patients with ischemic stroke and their prognosis according to the constitution of the cause of Oxfordshire Community Stroke Project (OCSP). Methods A prospective cohort study was conducted to consecutively register ischemic stroke patients admitted from January 2004 to July 2004. The patients were classified according to OCSP criteria and the relationship between OCSP subtypes and prognosis was analyzed. Results A total of 197 patients with ischemic stroke were enrolled. OCSP subtypes constituent ratio: 10.2% of the anterior circulation, 26.9% of partial anterior circulation infarction, 19.3% of the posterior circulation and lacunar infarction 43.6%. At the end of six months of each type, the mortality rate was 27.6% in all anterior circulation and 1.1% in lacunar infarction. There was a significant difference (P <0.05). The Barthel index score at the 6th month of each type showed the highest lacunar infarction (45.2%) and the lowest (7.4%) in the anterior circulation circulation, with significant difference (P <0.05). The number of recurrent cases in each type at the end of 6 months is small, and the conclusion remains to be further verified. Conclusion OCSP typing as an ischemic stroke based on clinical manifestations can provide a reference for the prognosis of ischemic stroke.