目的：探讨缺血性中风后脑性视野缺损的相关因素及对其远期预后的影响。

方法：回顾性研究，选取2021年1月至2023年7月本院收治的缺血性中风患者。在发病后第7 d进行视野检查，按是否出现脑性视野缺损分为脑性视野缺损组及非脑性视野缺损组。收集两组患者一般资料，行Logistic回归多因素分析影响缺血性中风后发生脑性视野缺损的因素，出院后均进行为期2 a随访，统计预后不良、复发及死亡例数。

结果：本研究共纳入缺血性中风患者218例，根据视野检查分为脑性视野缺损组54例(发生率为24.8%，男32例，女22例，平均年龄63.81±5.78岁)和非脑性视野缺损组164例(男95例，女59例，平均年龄62.78±6.01岁)。两组患者性别、BMI、文化程度、吸烟史、饮酒史、糖尿病、高血压、高脂血症、发病至入院时间及梗死类型比较均无差异(均P>0.05)，两组患者年龄、有无心房颤动、神经功能缺损程度、梗死部位、梗死体积比较均有差异(均P<0.05)。Logistic 回归多因素分析结果显示影响缺血性中风后脑性视野缺损发生的因素为入院时神经功能缺损程度(OR：5.106； 95%CI：1.034-25.205)、梗死部位\〖顶叶(OR：5.760； 95%CI：1.643-20.194)； 颞叶(OR：6.437； 95%CI：1.591-26.036)； 枕叶(OR：8.998； 95%CI：1.748-46.319))； 梗死体积(OR：5.123； 95%CI：1.318-19.906)。脑性视野缺损组预后不良及复发率均高于非脑性视野缺损组(均P<0.05)，两组患者死亡率比较无差异(P>0.05)。

结论：缺血性中风后脑性视野缺损的发生与病情严重程度、梗死部位及梗死体积有密切关联，且可导致远期预后不佳，需加强预防及治疗。

METHODS: A retrospective study was conducted on patients with ischemic stroke admitted to the hospital from January 2021 to July 2023. Visual field examination was performed 7 d after onset, and patients were divided into cerebral visual field defect group and non-cerebral visual field defect group according to whether cerebral visual field defect occurred. Demographic information and clinical indicators were collected from both groups, and multivariate Logistic regression analysis was performed to identify factors associated with cerebral visual field defect after ischemic stroke. After discharge, a 2-year follow-up was conducted to calculate the number of poor prognosis, recurrence, and death cases to evaluate long-term prognosis.

RESULTS:Among 218 patients with ischemic stroke, according to the visual field examination, 54 patients were in cerebral visual field defect group(incidence rate was 24.8%, 32 males and 22 females, mean age was 63.81±5.78 y)and 164 patients were in non-cerebral visual field defect group(95 males and 59 females, mean age was 62.78±6.01 y). There were no significant differences in gender, BMI, education level, smoking history, drinking history, diabetes, hypertension, hyperlipidemia, time from onset to admission, and type of infarction between the two groups(all P>0.05). There were significant differences in age, atrial fibrillation, degree of neurological deficit, infarct location and infarct volume between the two groups(all P<0.05). Multivariate Logistic regression analysis showed that the risk factor of cerebral visual field defect after ischemic stroke was the degree of neurological deficit at admission(OR: 5.106; 95%CI: 1.034-25.205), infarct location \〖parietal lobe(OR: 5.760; 95%CI: 1.643-20.194); temporal lobe(OR: 6.437; 95%CI: 1.591-26.036); occipital lobe(OR: 8.998; 95%CI:1.748-46.319)\〗,infarct volume(OR: 5.123; 95%CI: 1.318-19.906). The poor prognosis and recurrence rate in the cerebral visual field defect group were higher than those in the non-cerebral visual field defect group(both P<0.05), and there was no difference in mortality rate between the two groups(P>0.05).

CONCLUSION:The occurrence of cerebral visual field defects after ischemic stroke is closely related to the severity of the condition, infarct location and infarct volume infarction, and can lead to poor long-term prognosis. Therefore, prevention and treatment should be strengthened.