山东医药
山東醫藥
산동의약
SHANDONG MEDICAL JOURNAL
2014年
36期
8-10
,共3页
邱石%赵静%罗彬%吴涛%李继来%杜继臣
邱石%趙靜%囉彬%吳濤%李繼來%杜繼臣
구석%조정%라빈%오도%리계래%두계신
分水岭脑梗死%影像学%血流动力学障碍%栓塞%病因
分水嶺腦梗死%影像學%血流動力學障礙%栓塞%病因
분수령뇌경사%영상학%혈류동역학장애%전새%병인
cerebral watershed infarction%imaging%hemodynamic compromise%embolization%etiology
目的：探讨皮层分水岭脑梗死（ CWSI ）与内分水岭脑梗死（ IWSI ）的临床特征及发病机制。方法2012年10月～2014年5月连续收集入住航天中心医院（北京大学航天临床医学院）神经内科的分水岭脑梗死（ WSI ）患者，根据动脉支配特点分为CWSI组和IWSI组，比较两组患者的临床资料及影像学特点。结果本研究共纳入43例CWSI及31例IWSI患者。与IWSI组相比，CWSI组患者心房纤颤发生比例更高（P＝0．033），伴随皮质小梗死更为多见（P＝0．028）。而在IWSI组中，患者大脑中动脉狭窄程度≥50％或闭塞的比例更高，且梗死灶多呈串珠状或条索状（ P＝0．022、0．003）；IWSI组患者出院时NIHSS评分更高、住院时间更长（ P＝0．027、0．031）。两组Willis环血流代偿无明显差异（ P＞0．05）。结论 CWSI的主要发病机制是栓塞机制，而血流动力学障碍可能是IWSI的主要发病机制；IWSI患者的短期临床预后较CWSI患者更差。
目的：探討皮層分水嶺腦梗死（ CWSI ）與內分水嶺腦梗死（ IWSI ）的臨床特徵及髮病機製。方法2012年10月～2014年5月連續收集入住航天中心醫院（北京大學航天臨床醫學院）神經內科的分水嶺腦梗死（ WSI ）患者，根據動脈支配特點分為CWSI組和IWSI組，比較兩組患者的臨床資料及影像學特點。結果本研究共納入43例CWSI及31例IWSI患者。與IWSI組相比，CWSI組患者心房纖顫髮生比例更高（P＝0．033），伴隨皮質小梗死更為多見（P＝0．028）。而在IWSI組中，患者大腦中動脈狹窄程度≥50％或閉塞的比例更高，且梗死竈多呈串珠狀或條索狀（ P＝0．022、0．003）；IWSI組患者齣院時NIHSS評分更高、住院時間更長（ P＝0．027、0．031）。兩組Willis環血流代償無明顯差異（ P＞0．05）。結論 CWSI的主要髮病機製是栓塞機製，而血流動力學障礙可能是IWSI的主要髮病機製；IWSI患者的短期臨床預後較CWSI患者更差。
목적：탐토피층분수령뇌경사（ CWSI ）여내분수령뇌경사（ IWSI ）적림상특정급발병궤제。방법2012년10월～2014년5월련속수집입주항천중심의원（북경대학항천림상의학원）신경내과적분수령뇌경사（ WSI ）환자，근거동맥지배특점분위CWSI조화IWSI조，비교량조환자적림상자료급영상학특점。결과본연구공납입43례CWSI급31례IWSI환자。여IWSI조상비，CWSI조환자심방섬전발생비례경고（P＝0．033），반수피질소경사경위다견（P＝0．028）。이재IWSI조중，환자대뇌중동맥협착정도≥50％혹폐새적비례경고，차경사조다정천주상혹조색상（ P＝0．022、0．003）；IWSI조환자출원시NIHSS평분경고、주원시간경장（ P＝0．027、0．031）。량조Willis배혈류대상무명현차이（ P＞0．05）。결론 CWSI적주요발병궤제시전새궤제，이혈류동역학장애가능시IWSI적주요발병궤제；IWSI환자적단기림상예후교CWSI환자경차。
Objective To investigate the etiology and clinical features for cortical watershed infarction ( CWSI ) and internal watershed infarction (IWSI).Methods Patients with cerebral watershed infarction (WSI) were recruited from October 2012 to May 2014 in the department of neurology of Aerospace Center Hospital ( Aerospace Clinical Medical Col-lege Affiliated to Peking University), who were divided into CWSI group (n=43) and IWSI group (n=31) based on vas-cular teritories.Clinical and demographic features and neuroradiological features were compared between two groups .Re-sults Compared with the IWSI group , CWSI group had a higher incidence of atrial fibrillation and more frequently con-comitant small cortical infarcts (P=0.033 and P=0.028, respectively).In contrast, IWSI group had a higher degree of stenosis or occlusion in the middle cerebral artery (P=0.022) and exhibited a rosary-like pattern of infarction more fre-quently (P=0.003).Patients in IWSI group had higher NIHSS scores before discharge and longer hospital stay than CWSI group (P=0.027 and P=0.031, respectively).No significance was found between two groups in the colleteral ability of Willis circle (P>0.05).Conclusions CWSI are caused mainly by embolic pathogenesis , whereas hemodynamic com-promise appears to contribute greatly to the genesis of IWSI .Patients with IWSI show poor early clinical courses .
