CAJ | 학술논문

目的采用血管造影(DSA)分析老年脑梗死患者急性期脑血管病变的特点及其预后.方法对432例脑梗死患者进行主动脉弓十全脑DSA,并按年龄分为老年组320例和非老年组112例,研究分析两组患者脑动脉狭窄程度及分布情况,及其与相关危险因素的关系和预后.结果老年组有270例(84.3%)存在脑动脉狭窄,其中单纯颅外动脉狭窄98例(30.6%),颅内合并颅外动脉狭窄132例(41.3%),均明显高于非老年组(25.0%)(P＜0.05,P＜0.01);老年组中重度动脉狭窄224处(52.1%),也高于非老年组的51处(40.8%)(P＜0.05).老年组有心脑血管病史的比例高于非老年组,其预后[美国国立卫生院神经功能缺损评分(NIHSS)、再发脑卒中和病死率]也较非老年组差(P＜0.05～0.01).结论老年脑梗死患者脑动脉狭窄程度严重、多支病变的比例增高,预后较差,应尽早积极治疗,并做好二级预防和康复治疗以改善其预后.
목적 채용혈관조영(DSA)분석노년뇌경사환자급성기뇌혈관병변적특점급기예후.방법 대432례뇌경사환자진행주동맥궁십전뇌DSA,병안년령분위노년조320례화비노년조112례,연구분석량조환자뇌동맥협착정도급분포정황,급기여상관위험인소적관계화예후.결과 노년조유270례(84.3%)존재뇌동맥협착,기중단순로외동맥협착98례(30.6%),로내합병로외동맥협착132례(41.3%),균명현고우비노년조(25.0%)(P＜0.05,P＜0.01);노년조중중도동맥협착224처(52.1%),야고우비노년조적51처(40.8%)(P＜0.05).노년조유심뇌혈관병사적비례고우비노년조,기예후[미국국립위생원신경공능결손평분(NIHSS)、재발뇌졸중화병사솔]야교비노년조차(P＜0.05～0.01).결론 노년뇌경사환자뇌동맥협착정도엄중、다지병변적비례증고,예후교차,응진조적겁치료,병주호이급예방화강복치료이개선기예후.
Objective To investigate the distribution and severity of cerebral artery stenosis and the prognosis in elderly patients with acute cerebral infarction using digital subtraction angiography (DSA). Methods The 432 elderly patients with acute cerebral ischemia infarction underwent DSA,and they were divided into two groups: elderly group (n= 320) and non-elderly group (n= 112). The characteristics of distribution and severity of cerebral artery stenosis, the relationship between artery stenosis and relative risk factors, and the prognosis of acute cerebral infarction were analyzed.Results In elderly group, 270 cases (84.3%) had intra- and extra- cranial artery stenosis, of which 98 patients (30.6%) with pure extracranial arterial stenosis, 132 patients (41.3%) with combined extra- and intra-cranial artery stenosis. They were both significantly higher than the corresponding data in non-elderly group [23 cases (20.5%) and 28 cases (25%), P＜0.05 and 0.01]. The prevalences of moderate and severe cerebral artery stenosises were higher in elderly group than in nonelderly group [224 locations (52.1%) vs. 51 locations (40.8%), P＜0. 05]. The number of patients with previous history of cerebrovascular disease was much more and the prognosis was much worse in elderly group than in non-elderly group (both P＜0.05), Conclusions The elderly patients with cerebral infarction have severer cerebral artery stenosis, increased proportion of multivessel disease and poor prognosis. So it is very important to take aggressive treatment as soon as possible, and to make secondary prevention and effective rehabilitation so as to improve their prognosis.