Abstract:

Objective  To observe the effect of chronic obstructive pulmonary disease (COPD) on the prognosis of patients with acute cerebral infarction.  Methods  A total of 60 acute cerebral infarction patients were diagnosed by CT or MRI. According to whether the patients were suffering from COPD or not, they were divided into COPD group (N = 30) or control group (N = 30). The neurological deficit was evaluated by National Institutes of Health Stroke Scale (NIHSS), and the ability of daily life was evaluated by Barthel Index (BI) on patients in both groups at admission, and 14 and 28 d after treatment. The prognosis of patients was evaluated and compared between 2 groups.  Results  There were no significant differences between 2 groups in the general data, NIHSS and BI scores before treatment (P > 0.05, for all). After 14 d of treatment, the NIHSS score (9.47 ± 3.43) was slightly higher, BI score (33.83 ± 15.68) was slightly lower in COPD group, but compared with those in control group (NIHSS score: 8.37 ± 3.50, BI score: 37.83 ± 17.25), there were no significant differences (P = 0.224, 0.351, respectively). After 28 d of treatment, the NIHSS score in COPD group (6.93 ± 2.59) was significantly higher than that in control group (5.43 ± 2.13, P = 0.017), and BI score in COPD group (54.00 ± 15.45) was significantly lower than that in control group (65.67 ± 16.33, P = 0.006).  Conclusions  The prognosis of patients with acute cerebral infarction was affected by COPD, which may be related to the existence of systemic inflammation and oxidative stress in COPD patients.

Key words: Brain infarction, Pulmonary disease, chronic obstructive, Prognosis

摘要：

目的 探讨慢性阻塞性肺病对急性脑梗死患者预后的影响。方法 采用美国国立卫生研究院卒中量表（NIHSS）和Barthel 指数（BI）对慢性阻塞性肺病合并急性脑梗死（COPD 组）患者发病不同阶段（入院时、治疗第14 和28 天）神经功能缺损程度和日常生活活动能力进行评分，与单纯急性脑梗死（对照组）患者进行比较，评价其预后。结果 治疗前两组一般情况、NIHSS 和BI评分差异均无统计学意义（P > 0.05）。治疗第14 天时，COPD 组患者NIHSS 评分升高［（9.47±3.43）分］、BI 评分降低［（33.83 ± 15.68）分］，但与对照组［NIHSS 评分：（8.37 ± 3.50）分，BI评分：（37.83 ± 17.25）分］比较差异无统计学意义（P = 0.224，0.351）。治疗第28 天时，COPD 组患者NIHSS 评分［（6.93 ± 2.59）分］高于、BI 评分［（54.00 ± 15.45）分］低于对照组［NIHSS 评分：（5.43 ± 2.13）分，BI 评分：（65.67 ± 16.33）分］，差异具有统计学意义（P = 0.017，0.006）。结论 慢性阻塞性肺病合并急性脑梗死患者发病后预后不良可能与病程中始终存在的系统性炎症和氧化应激有关。

关键词: 脑梗死, 肺疾病, 慢性阻塞性, 预后