中华神经科杂志
中華神經科雜誌
중화신경과잡지
Chinese Journal of Neurology
2011年
12期
832-835
,共4页
脑淀粉样血管病%高血压%脑出血%回顾性研究
腦澱粉樣血管病%高血壓%腦齣血%迴顧性研究
뇌정분양혈관병%고혈압%뇌출혈%회고성연구
Cerebral amyloid angiopathy%Hypertension%Cerebral hemorrhage%Retrospective studies
目的 总结26例尸检证实的淀粉样脑血管病的临床资料特点,以提高对本病的认识和诊断水平.方法 回顾性分析我院1983--1999年收治的经尸检证实的26例淀粉样脑血管病患者,总结其既往史、临床表现、实验室检查等临床资料.结果 26例淀粉样脑血管病中男17例,女9例,年龄45 ～78岁,有高血压病史者8例(30.7％),糖尿病病史者6例(23.1％).2例患者(7.6％)正服用抗凝或扰血小板剂,均为多发脑叶出血.26例中脑出血20例,其中单发脑叶出血2例,多灶性脑叶出血8例,壳核出血5例,丘脑及小脑出血各2例,脑干出血1例.蛛网膜下腔出血2例,出血性脑梗死、基底节区梗死、椎基底动脉闭塞及硬膜下血肿各1例.20例淀粉样脑血管病脑出血患者临床表现为头痛、肢体瘫痪、昏迷、抽搐等.结论 淀粉样脑血管病临床上常以脑血管病表现形式起病,伴有或不伴有高血压.脑叶出血是淀粉样脑血管病最常见临床表现,但少数也可见基底节、小脑和脑干出血.淀粉样脑血管病也可表现为脑梗死、蛛网膜下腔出血.抗凝剂(如华法林)及抗血小板药物(如阿司匹林)的应用对淀粉样脑血管病脑出血可能具有一定的促发作用.
目的 總結26例尸檢證實的澱粉樣腦血管病的臨床資料特點,以提高對本病的認識和診斷水平.方法 迴顧性分析我院1983--1999年收治的經尸檢證實的26例澱粉樣腦血管病患者,總結其既往史、臨床錶現、實驗室檢查等臨床資料.結果 26例澱粉樣腦血管病中男17例,女9例,年齡45 ～78歲,有高血壓病史者8例(30.7％),糖尿病病史者6例(23.1％).2例患者(7.6％)正服用抗凝或擾血小闆劑,均為多髮腦葉齣血.26例中腦齣血20例,其中單髮腦葉齣血2例,多竈性腦葉齣血8例,殼覈齣血5例,丘腦及小腦齣血各2例,腦榦齣血1例.蛛網膜下腔齣血2例,齣血性腦梗死、基底節區梗死、椎基底動脈閉塞及硬膜下血腫各1例.20例澱粉樣腦血管病腦齣血患者臨床錶現為頭痛、肢體癱瘓、昏迷、抽搐等.結論 澱粉樣腦血管病臨床上常以腦血管病錶現形式起病,伴有或不伴有高血壓.腦葉齣血是澱粉樣腦血管病最常見臨床錶現,但少數也可見基底節、小腦和腦榦齣血.澱粉樣腦血管病也可錶現為腦梗死、蛛網膜下腔齣血.抗凝劑(如華法林)及抗血小闆藥物(如阿司匹林)的應用對澱粉樣腦血管病腦齣血可能具有一定的促髮作用.
목적 총결26례시검증실적정분양뇌혈관병적림상자료특점,이제고대본병적인식화진단수평.방법 회고성분석아원1983--1999년수치적경시검증실적26례정분양뇌혈관병환자,총결기기왕사、림상표현、실험실검사등림상자료.결과 26례정분양뇌혈관병중남17례,녀9례,년령45 ～78세,유고혈압병사자8례(30.7％),당뇨병병사자6례(23.1％).2례환자(7.6％)정복용항응혹우혈소판제,균위다발뇌협출혈.26례중뇌출혈20례,기중단발뇌협출혈2례,다조성뇌협출혈8례,각핵출혈5례,구뇌급소뇌출혈각2례,뇌간출혈1례.주망막하강출혈2례,출혈성뇌경사、기저절구경사、추기저동맥폐새급경막하혈종각1례.20례정분양뇌혈관병뇌출혈환자림상표현위두통、지체탄탄、혼미、추휵등.결론 정분양뇌혈관병림상상상이뇌혈관병표현형식기병,반유혹불반유고혈압.뇌협출혈시정분양뇌혈관병최상견림상표현,단소수야가견기저절、소뇌화뇌간출혈.정분양뇌혈관병야가표현위뇌경사、주망막하강출혈.항응제(여화법림)급항혈소판약물(여아사필림)적응용대정분양뇌혈관병뇌출혈가능구유일정적촉발작용.
Objective To study the clinical feature of 26 cases which were diagnosed pathologically as cerebral amyloid angiopathy ( CAA ) and to improve the level of diagnosis.Methods The clinical characteristics of the 26 cases with CAA in our hospital from 1983 to 1999 were retrospectively reviewed and analyzed,including previous history,clinical manifestation,and laboratory examination.Results Of the 26 CAA patients,there were 17 men and 9 women with age ranging from 45 to 78 years.Eight patients (30.7％ ) had the history of hypertension; 6 cases (23.1％ ) suffered from diabetes; 2 patients(7.6％ ) were taking anticoagulant or antiplatelet agents in whom serious CAA and multiple hemorrhages were histopathologically confirmed by autopsy.There were 20 cases diagnosed as cerebral hemorrhage,including 2 patients with single lobe hemorrhage,8 patients with multiple lobe hemorrhage,5 patients with putamen hemorrhage,2 patients with cerebral ganglion hemorrhage,2 patients with cerebellar hemorrhage,and 1 patient with brain stem hemorrhage.Of the 26 CAA patients,there were 2 patients with subaracchnoid hemorrhage,1 patient with hemorrhagic cerebral infarction,1 patient with basal ganglia infarction,1 patient with basilar artery occlusion,1 patient with subdural hematoma.The clinical manifestation of the 20 cases diagnosed as cerebral hemorrhage included headache,limb palsy,coma,and hyperspasmia.Conclusions CAA always begin as cerebrovascular disease symptoms with or without hypertension.The most common manifestation of CAA is lobe hemorrhage,while the CAA-related hemorrhage seldom occurs in basal ganglia,cerebellum and brainstem.CAA can also manifest cerebral infarction and subarachnoid hemorrhage.Anticoagulant (warfarin) or antiplatelet agents (aspirin) maybe a contributing factor for CAA-related hemorrhage.
