中国医药
中國醫藥
중국의약
CHINA MEDICINE
2010年
9期
827-829
,共3页
脑梗死%微栓子监测%磁共振成像,弥散
腦梗死%微栓子鑑測%磁共振成像,瀰散
뇌경사%미전자감측%자공진성상,미산
Cerebral infarction%Microembolic signal monitoring%Diffusion weighted imaging,dispersion
目的 比较经颅多普勒微栓子监测有、无微栓子信号的颅内大动脉狭窄所致急性脑梗死患者的临床特点,观察微栓子信号的转归.方法 收集存在颅内大动脉狭窄的发病7 d内的急性脑梗死患者,在人院第1天和第7天进行经颅多普勒监测相应的狭窄动脉半小时以及磁共振弥散加权成像检查.确定有无微栓子信号,判断新发梗死灶的数目及分布.详细记录所有临床特点,美国国立卫生院神经功能缺损评分(NIHSS),用药情况.结果 共收集资料齐全的31例患者,其中12例患者存在微栓子信号.存在微栓子信号的患者NIHSS低于无微栓子信号的患者[(3.83±3.16)分比(7.00±3.93)分,P=0.026];平均年龄亦有低于无微栓子信号患者的倾向[(60.17±18.91)岁比(68.79±11.44)岁,P=0.174];女性患者存在微栓子信号的比例偏高(6/12比3/19,P=0.056);存在微栓子信号的患者磁共振弥散加权成像上存在多发性梗死灶的比例高(6/12比4/15,P=0.093).结论 存在微栓子信号的大动脉狭窄患者发生脑梗死的年龄偏早,而卒中严重程度相对较轻.存在微栓子信号的患者磁共振弥散加权成像上病灶多为多发性梗死.卒中发生后微栓子信号可能随时间延长和抗血小板药物的治疗而减少或消失.
目的 比較經顱多普勒微栓子鑑測有、無微栓子信號的顱內大動脈狹窄所緻急性腦梗死患者的臨床特點,觀察微栓子信號的轉歸.方法 收集存在顱內大動脈狹窄的髮病7 d內的急性腦梗死患者,在人院第1天和第7天進行經顱多普勒鑑測相應的狹窄動脈半小時以及磁共振瀰散加權成像檢查.確定有無微栓子信號,判斷新髮梗死竈的數目及分佈.詳細記錄所有臨床特點,美國國立衛生院神經功能缺損評分(NIHSS),用藥情況.結果 共收集資料齊全的31例患者,其中12例患者存在微栓子信號.存在微栓子信號的患者NIHSS低于無微栓子信號的患者[(3.83±3.16)分比(7.00±3.93)分,P=0.026];平均年齡亦有低于無微栓子信號患者的傾嚮[(60.17±18.91)歲比(68.79±11.44)歲,P=0.174];女性患者存在微栓子信號的比例偏高(6/12比3/19,P=0.056);存在微栓子信號的患者磁共振瀰散加權成像上存在多髮性梗死竈的比例高(6/12比4/15,P=0.093).結論 存在微栓子信號的大動脈狹窄患者髮生腦梗死的年齡偏早,而卒中嚴重程度相對較輕.存在微栓子信號的患者磁共振瀰散加權成像上病竈多為多髮性梗死.卒中髮生後微栓子信號可能隨時間延長和抗血小闆藥物的治療而減少或消失.
목적 비교경로다보륵미전자감측유、무미전자신호적로내대동맥협착소치급성뇌경사환자적림상특점,관찰미전자신호적전귀.방법 수집존재로내대동맥협착적발병7 d내적급성뇌경사환자,재인원제1천화제7천진행경로다보륵감측상응적협착동맥반소시이급자공진미산가권성상검사.학정유무미전자신호,판단신발경사조적수목급분포.상세기록소유림상특점,미국국립위생원신경공능결손평분(NIHSS),용약정황.결과 공수집자료제전적31례환자,기중12례환자존재미전자신호.존재미전자신호적환자NIHSS저우무미전자신호적환자[(3.83±3.16)분비(7.00±3.93)분,P=0.026];평균년령역유저우무미전자신호환자적경향[(60.17±18.91)세비(68.79±11.44)세,P=0.174];녀성환자존재미전자신호적비례편고(6/12비3/19,P=0.056);존재미전자신호적환자자공진미산가권성상상존재다발성경사조적비례고(6/12비4/15,P=0.093).결론 존재미전자신호적대동맥협착환자발생뇌경사적년령편조,이졸중엄중정도상대교경.존재미전자신호적환자자공진미산가권성상상병조다위다발성경사.졸중발생후미전자신호가능수시간연장화항혈소판약물적치료이감소혹소실.
Objective To compare the clinical characteristics of acute cerebral infarction patients with or without microembolic signal ( MES) and to investigate the prognosis of MES. Methods Acute cerebral infarction patients (within 7 days) were included into our study. Thirty minutes of transcranial doppler(TCD) monitoring for MES was performed on admission and on 7th day after admission. Diffusion weighted imagin ( DW1) was performed on admission to investigate the number of new infarctions. Clinical data including risk factors, NIHSS and drugs were recorded detailed. Results Thirty-one patients were enrolled into our study, among which 12 patients were found with MES. The NIHSS in patients with MES was found lower than that in patient without MES(3.83 ±3. 16 vs 7.00 ±3.93, P=0.026). The frequency of MES in female was found higher than that in male(6/12 vs 3/19, P =0.056). The age of patients with MES was younger than that of patients without MES(60. 17 ± 18.91 vs 68. 79 ± 11.44, P =0.174). The patients with MES was found with more frequency of multiple infarcts on DWI(6/12 vs 4/ 15, P =0. 093). The medium of MES number reduced significantly on day 7(8 vs 1, P =0.041) , among which 5 patients were found disappearance of MES on day 7. Conclusions The acute cerebral infarct patients with large artery stenosis and MES are younger than those without MES and the severity of stroke was not as severe as those without MES. Multiple infarets can be found much more frequently in patients with MES than those without MES. The MES maybe disappear as time goes by and may be due to the use of antiplatelet drugs.
