实用临床医学
實用臨床醫學
실용림상의학
Practical Clinical Medicine
2014年
3期
1-4
,共4页
陈淦%周利胜%何杏玲%杨水泉
陳淦%週利勝%何杏玲%楊水泉
진감%주리성%하행령%양수천
急性脑梗死%短暂性脑缺血发作%脑微出血%临床特点
急性腦梗死%短暫性腦缺血髮作%腦微齣血%臨床特點
급성뇌경사%단잠성뇌결혈발작%뇌미출혈%림상특점
acute cerebral infarct%transient ischemic attack%cerebral microbleeds%clinical features
目的:比较急性脑梗死与短暂性脑缺血发作的危险因素及病理生理TOAST分型,以及这两种缺血性脑血管病有无脑微出血的临床特点,探讨急性脑梗死与短暂性脑缺血发作的病理生理机制和脑微出血在缺血性脑血管病治疗中的意义。方法对急性脑梗死患者86例(ACI组)和短暂性脑缺血发作患者26例(TIA组)进行磁共振梯度回波序列检查,根据有无脑微出血(CMBs)将112例患者分为有CMBs组与无CMBs组。比较ACI组、TIA组的危险因素、病理生理TOAST 分型及有CMBs 组与无CMBs 组的危险因素。结果 ACI 组CMBs 发生率显著高于TIA 组(23.3%比3.8%,P<0.05);在病理生理TOAST分型中,TIA组大动脉粥样硬化型显著高于ACI组(26.9%比9.3%,P<0.05);ACI组、TIA组患者的年龄、性别及高血压、糖尿病、吸烟、总胆固醇、心房纤颤、T2白质高信号评分比较差异均无统计学意义(P>0.05)。有CMBs组收缩压、T2白质高信号的评分均显著高于无CMBs组(P<0.05)。结论急性脑梗死患者脑微出血较短暂性脑缺血发作患者常见,短暂性脑缺血发作的病理生理机制中大动脉粥样硬化较急性脑梗死多见;收缩压水平和T2白质高信号评分是脑微出血的危险因素。
目的:比較急性腦梗死與短暫性腦缺血髮作的危險因素及病理生理TOAST分型,以及這兩種缺血性腦血管病有無腦微齣血的臨床特點,探討急性腦梗死與短暫性腦缺血髮作的病理生理機製和腦微齣血在缺血性腦血管病治療中的意義。方法對急性腦梗死患者86例(ACI組)和短暫性腦缺血髮作患者26例(TIA組)進行磁共振梯度迴波序列檢查,根據有無腦微齣血(CMBs)將112例患者分為有CMBs組與無CMBs組。比較ACI組、TIA組的危險因素、病理生理TOAST 分型及有CMBs 組與無CMBs 組的危險因素。結果 ACI 組CMBs 髮生率顯著高于TIA 組(23.3%比3.8%,P<0.05);在病理生理TOAST分型中,TIA組大動脈粥樣硬化型顯著高于ACI組(26.9%比9.3%,P<0.05);ACI組、TIA組患者的年齡、性彆及高血壓、糖尿病、吸煙、總膽固醇、心房纖顫、T2白質高信號評分比較差異均無統計學意義(P>0.05)。有CMBs組收縮壓、T2白質高信號的評分均顯著高于無CMBs組(P<0.05)。結論急性腦梗死患者腦微齣血較短暫性腦缺血髮作患者常見,短暫性腦缺血髮作的病理生理機製中大動脈粥樣硬化較急性腦梗死多見;收縮壓水平和T2白質高信號評分是腦微齣血的危險因素。
목적:비교급성뇌경사여단잠성뇌결혈발작적위험인소급병리생리TOAST분형,이급저량충결혈성뇌혈관병유무뇌미출혈적림상특점,탐토급성뇌경사여단잠성뇌결혈발작적병리생리궤제화뇌미출혈재결혈성뇌혈관병치료중적의의。방법대급성뇌경사환자86례(ACI조)화단잠성뇌결혈발작환자26례(TIA조)진행자공진제도회파서렬검사,근거유무뇌미출혈(CMBs)장112례환자분위유CMBs조여무CMBs조。비교ACI조、TIA조적위험인소、병리생리TOAST 분형급유CMBs 조여무CMBs 조적위험인소。결과 ACI 조CMBs 발생솔현저고우TIA 조(23.3%비3.8%,P<0.05);재병리생리TOAST분형중,TIA조대동맥죽양경화형현저고우ACI조(26.9%비9.3%,P<0.05);ACI조、TIA조환자적년령、성별급고혈압、당뇨병、흡연、총담고순、심방섬전、T2백질고신호평분비교차이균무통계학의의(P>0.05)。유CMBs조수축압、T2백질고신호적평분균현저고우무CMBs조(P<0.05)。결론급성뇌경사환자뇌미출혈교단잠성뇌결혈발작환자상견,단잠성뇌결혈발작적병리생리궤제중대동맥죽양경화교급성뇌경사다견;수축압수평화T2백질고신호평분시뇌미출혈적위험인소。
Objective To compare the risk factors, TOAST types and clinical characteristics of cerebral microbleeds(CMBs) between acute cerebral infarction(ACI)and transient ischemic attack (TIA), and to investigate the pathophysiologic mechanisms of ACI and TIA and the significance of CMBs in ischemic cerebrovascular disease. Methods Gradient echo MRI was performed in 86 ACI patients (ACI group) and 26 TIA patients (TIA group). In addition, these patients were divided into CMBs group and non-CMBs group. Risks factors and TOAST types were compared between ACI group and TIA group. Furthermore, risks factors were compared between CMBs group and non-CMBs group. Results Compared with TIA group, the incidence of CMBs increased but incidence of large artery atherosclerosis decreased in ACI group (23.3% vs 3.8% and 9.3% vs 26.9%, respectively; P<0.05). However, there were no significant differences in age, gender and scores of hypertension, diabetes, smoking, total cholesterol, atrial fibrillation and T2 white matter hyperintensity between the two groups (P>0.05).Compared with non-CMBs group,scores of systolic pressure and T2 white matter hyperintensity increased in CMBs group (P <0.05).Conclusion The incidence of CMBs in ACI patients is higher than that in TIA patients. The incidence of large artery atherosclerosis in TIA patients is higher than that in ACI patients. Systolic pressure and T2 white matter hyperintensity were the risk factors for CMBs.