CAJ | 학술논문

目的探讨高龄(≥80岁)缺血性脑卒中TOAST分型亚组患者的临床特征、影像学、血管学以及实验室检查结果等方面的差异.方法回顾分析神经科连续住院的91例高龄急性缺血性脑卒中患者的病历和影像学资料,根据TOAST分型进行分组,对各TOAST分型亚组患者的危险因素、临床表现、并发症、短期预后、影像学表现、脑血管病变以及实验室检查结果等情况进行分析对比.结果大动脉粥样硬化(34/91)是高龄缺血性脑卒中的最常见病因,罪犯血管多位于颅内(25/34).大动脉粥样硬化组颅内(28/34)和颅外(12/34)脑动脉闭塞性病变患者比例均高于其他各组.心脏源性栓塞组患者血脂水平偏低,短期预后不良(7/15)患者比例高于大动脉粥样硬化组和小动脉闭塞组,严重脑水肿(4/15)患者比例高于其他各组,后循环梗死(1/15)和脑白质病变(3/15)患者比例低于小动脉闭塞组.小动脉闭塞组出现并发症(4/20)患者较少,无短期预后不良.结论高龄缺血性脑卒中各TOAST分型亚组患者的临床特征、影像学表现、脑血管病变以及实验室检查结果等方面均存在不同程度的差异,上述差异的临床意义有待进一步探索.
목적 탐토고령(≥80세)결혈성뇌졸중TOAST분형아조환자적림상특정、영상학、혈관학이급실험실검사결과등방면적차이.방법 회고분석신경과련속주원적91례고령급성결혈성뇌졸중환자적병력화영상학자료,근거TOAST분형진행분조,대각TOAST분형아조환자적위험인소、림상표현、병발증、단기예후、영상학표현、뇌혈관병변이급실험실검사결과등정황진행분석대비.결과 대동맥죽양경화(34/91)시고령결혈성뇌졸중적최상견병인,죄범혈관다위우로내(25/34).대동맥죽양경화조로내(28/34)화로외(12/34)뇌동맥폐새성병변환자비례균고우기타각조.심장원성전새조환자혈지수평편저,단기예후불량(7/15)환자비례고우대동맥죽양경화조화소동맥폐새조,엄중뇌수종(4/15)환자비례고우기타각조,후순배경사(1/15)화뇌백질병변(3/15)환자비례저우소동맥폐새조.소동맥폐새조출현병발증(4/20)환자교소,무단기예후불량.결론 고령결혈성뇌졸중각TOAST분형아조환자적림상특정、영상학표현、뇌혈관병변이급실험실검사결과등방면균존재불동정도적차이,상술차이적림상의의유대진일보탐색.
Objective To evaluate the differences of clinical features,neuroimaging,angiography and laboratory findings between different stroke subtypes according to TOAST criteria in elderly patients.Methods 91 patients (aged ≥ 80 years) with acute ischemic stroke were retrospectively reviewed in Departement of Neurology from April 2009 to August 2010.Subtypes of ischemic stroke were analyzed according to the classification of TOAST.Risk factors,clinical manifestations,complications,prognosis,neuroimaging,cerebrovascular lesions,and laboratory findings of different TOAST subtypes were compared.Results Large-artery atherosclerosis (LAA) (34/91) was the most common cause of acute ischemic stroke in elderly patients,and most criminal lesions (25/34) located at the intracranial arteries.In the LAA group,patients with intracranial (25/34) or extracranial (12/34) occlusive diseases were more than those in other groups.Patients with cardioembolism (CE) had lower lipid levels.In the CE group,patients with poor shortterm prognosis (7/15) were more than in the LAA or small-artery occlusion (SAO) group,and patients with severe cerebral edema (4/15) were more than those in other groups.In patients of the SAO group,complications occurred infrequently (4/20),and none had poor short-term prognosis.Conclusions There were some differences among different TOAST subtypes in clinical features,neuroimaging,cerebrovascular diseases,and laboratory findings.The clinical significance of our findings needs to be explored further.