中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2014年
16期
22-24
,共3页
陈素芬%刘祝钦%胡珏%黄立新
陳素芬%劉祝欽%鬍玨%黃立新
진소분%류축흠%호각%황립신
进展性缺血性卒中%颈部血管斑块形成%血糖%梗死部位
進展性缺血性卒中%頸部血管斑塊形成%血糖%梗死部位
진전성결혈성졸중%경부혈관반괴형성%혈당%경사부위
The stroke in progression%The formation of carotid plaque%Blood glucose%Infarction region
目的：探讨脑梗死部位与缺血性进展性卒中的关系，为早期识别进展性卒中提供可能的影像学依据。方法：回顾性分析发病48 h内入院治疗的653例脑梗死患者的病例资料，根据缺血性进展性卒中诊断标准，将其分为进展性卒中组（进展组155例）和非进展性卒中组（对照组498例）；按梗死部位分为侧脑室体旁梗死（A型）、分水岭梗死（B型）、单个脑叶或基底节或大面积脑梗死（C型）、脑干和/或小脑梗死（D型）4型，比较各型的发生率，对缺血性进展性脑卒中的相关因素进行Logistic回归分析，筛选其发生的危险因素。结果：进展组中A型进展性卒中发病率最高，其次为B型，与其他类型及对照组比较差异均有统计学意义（P<0.05）；同组其他类型间比较差异无统计学意义（P>0.05）。进展组高血压病史和颈部血管斑块形成发生率显著高于非进展组（P<0.05）；进展组入院时血糖、胆固醇、甘油三酯水平显著高于非进展组（P<0.05）。颈部血管斑块形成、入院时高血糖、梗死部位与缺血性进展性脑卒中的发生相关（P<0.05）。结论：颈部血管斑块形成、入院时高血糖、梗死部位与缺血性进展性脑卒中的发生相关。侧脑室体旁梗死、分水岭梗死较易进展。
目的：探討腦梗死部位與缺血性進展性卒中的關繫，為早期識彆進展性卒中提供可能的影像學依據。方法：迴顧性分析髮病48 h內入院治療的653例腦梗死患者的病例資料，根據缺血性進展性卒中診斷標準，將其分為進展性卒中組（進展組155例）和非進展性卒中組（對照組498例）；按梗死部位分為側腦室體徬梗死（A型）、分水嶺梗死（B型）、單箇腦葉或基底節或大麵積腦梗死（C型）、腦榦和/或小腦梗死（D型）4型，比較各型的髮生率，對缺血性進展性腦卒中的相關因素進行Logistic迴歸分析，篩選其髮生的危險因素。結果：進展組中A型進展性卒中髮病率最高，其次為B型，與其他類型及對照組比較差異均有統計學意義（P<0.05）；同組其他類型間比較差異無統計學意義（P>0.05）。進展組高血壓病史和頸部血管斑塊形成髮生率顯著高于非進展組（P<0.05）；進展組入院時血糖、膽固醇、甘油三酯水平顯著高于非進展組（P<0.05）。頸部血管斑塊形成、入院時高血糖、梗死部位與缺血性進展性腦卒中的髮生相關（P<0.05）。結論：頸部血管斑塊形成、入院時高血糖、梗死部位與缺血性進展性腦卒中的髮生相關。側腦室體徬梗死、分水嶺梗死較易進展。
목적：탐토뇌경사부위여결혈성진전성졸중적관계，위조기식별진전성졸중제공가능적영상학의거。방법：회고성분석발병48 h내입원치료적653례뇌경사환자적병례자료，근거결혈성진전성졸중진단표준，장기분위진전성졸중조（진전조155례）화비진전성졸중조（대조조498례）；안경사부위분위측뇌실체방경사（A형）、분수령경사（B형）、단개뇌협혹기저절혹대면적뇌경사（C형）、뇌간화/혹소뇌경사（D형）4형，비교각형적발생솔，대결혈성진전성뇌졸중적상관인소진행Logistic회귀분석，사선기발생적위험인소。결과：진전조중A형진전성졸중발병솔최고，기차위B형，여기타류형급대조조비교차이균유통계학의의（P<0.05）；동조기타류형간비교차이무통계학의의（P>0.05）。진전조고혈압병사화경부혈관반괴형성발생솔현저고우비진전조（P<0.05）；진전조입원시혈당、담고순、감유삼지수평현저고우비진전조（P<0.05）。경부혈관반괴형성、입원시고혈당、경사부위여결혈성진전성뇌졸중적발생상관（P<0.05）。결론：경부혈관반괴형성、입원시고혈당、경사부위여결혈성진전성뇌졸중적발생상관。측뇌실체방경사、분수령경사교역진전。
Objective:To explore the relationship of the infarction region and the stroke in progression,and find the potential imaging evidence for discriminating the stroke in progression in earlier period. Method:The original data of 653 cases of cerebral infarction who presented within 48 hours of onset were retrospectively analyzed. According to the diagnostic criteria of stroke in progression(SIP),all the patients were divided into stroke in progression group(progressive group,155 cases)and non-progression stroke group(control group,498 cases). And according to the infarction region, they were divided into 4 types,such as the body of lateral ventricle infarction(type A),cerebral watershed infarction(type B),single lobe or basal ganglia or large-area cerebral infarction(type C),and brain stem and(or)cerebellar infarction (group D). Then,the incidence of various types were compared,the related factors of SIP were analyzed by logistic regression method for screening the risk factors. Result:In the progressive group,the incidence of type A was the highest than the other types,followed by type B,there were significant difference compared with other types and the control group (P<0.05),and no significant difference between the other types(P>0.05). The rate of having the history of hypertension and the formation of carotid plaque were significantly higher than them in the control group(P<0.05). The levels of blood glucose at admission,cholesterol,triglyceride were significantly higher than them in the control group(P<0.05). There were relevance between SIP with the formation of carotid plaque,the high level of blood glucose at admission and infarction region(P<0.05).Conclusion:There is relevance between SIP with the formation of carotid plaque,the high level of blood glucose at admission and infarction region. Around the body of lateral ventricle infarction and cerebral watershed infarction is easy to deteriorate.
