中国医药
中國醫藥
중국의약
CHINA MEDICINE
2014年
11期
1602-1606
,共5页
赵丽丽%马洪颖%李瑜霞%刘春芹%李永秋
趙麗麗%馬洪穎%李瑜霞%劉春芹%李永鞦
조려려%마홍영%리유하%류춘근%리영추
脑梗死%脉络膜前动脉%血管狭窄%预后
腦梗死%脈絡膜前動脈%血管狹窄%預後
뇌경사%맥락막전동맥%혈관협착%예후
Brain infarction%Anterior choroidal artery%Carotid stenosis%Prognosis
目的 探讨进展性脉络膜前动脉(AchA)供血区新发脑梗死的可能机制以及预后.方法 连续性前瞻性分析96例局限于AchA供血区新发脑梗死患者,根据入院后1周内美国国立卫生研究院卒中量表(NIHSS)评分将患者分为2组:病情进展组(42例)和病情非进展组(54例).所有患者均进行颈动脉血管超声、头部CT血管造影(CTA)或磁共振血管造影(MRA)等检查.比较2组患者颈动脉粥样硬化和血管狭窄程度的差别.随访3个月,比较2组患者的预后.结果 所有局限于AchA供血区脑梗死患者中均以高血压为特征,在病情进展组其糖尿病病史、高脂血症构成比[35.7％ (15/42)、59.5％(25/42)]明显高于病情非进展组[14.8％ (8/54)、37.0％ (20/54)].病情进展组共检出不稳定斑块71.4％(30例),明显高于病情非进展组38.9％(21例)(x2=4.42,P=0.036).病情进展组有血管狭窄比例78.6％(33例)明显高于病情非进展组57.4％(31例)(x2=4.76,P=0.029).其中病情进展组同侧颈内动脉或大脑中动脉狭窄率64.3％(27例)明显高于病情非进展组38.9％(21例)(x2=6.10,P=0.014).并且病情进展组同侧颈内动脉或大脑中动脉中重度狭窄-闭塞的比率(47.6％,20例)明显高于病情非进展组(16.7％,9例)(x2=4.81,P =0.028).随访3个月后病情进展组有12例(30.0％)好转,明显低于病情非进展组的28例(54.9％)(x2=5.64,P=0.018).结论 糖尿病、高脂血症可能是进展性AchA脑梗死的重要影响因素.进展性AchA脑梗死可能存在明显的颈内动脉或大脑中动脉中重度狭窄-闭塞病变,其预后差、复发率高.
目的 探討進展性脈絡膜前動脈(AchA)供血區新髮腦梗死的可能機製以及預後.方法 連續性前瞻性分析96例跼限于AchA供血區新髮腦梗死患者,根據入院後1週內美國國立衛生研究院卒中量錶(NIHSS)評分將患者分為2組:病情進展組(42例)和病情非進展組(54例).所有患者均進行頸動脈血管超聲、頭部CT血管造影(CTA)或磁共振血管造影(MRA)等檢查.比較2組患者頸動脈粥樣硬化和血管狹窄程度的差彆.隨訪3箇月,比較2組患者的預後.結果 所有跼限于AchA供血區腦梗死患者中均以高血壓為特徵,在病情進展組其糖尿病病史、高脂血癥構成比[35.7％ (15/42)、59.5％(25/42)]明顯高于病情非進展組[14.8％ (8/54)、37.0％ (20/54)].病情進展組共檢齣不穩定斑塊71.4％(30例),明顯高于病情非進展組38.9％(21例)(x2=4.42,P=0.036).病情進展組有血管狹窄比例78.6％(33例)明顯高于病情非進展組57.4％(31例)(x2=4.76,P=0.029).其中病情進展組同側頸內動脈或大腦中動脈狹窄率64.3％(27例)明顯高于病情非進展組38.9％(21例)(x2=6.10,P=0.014).併且病情進展組同側頸內動脈或大腦中動脈中重度狹窄-閉塞的比率(47.6％,20例)明顯高于病情非進展組(16.7％,9例)(x2=4.81,P =0.028).隨訪3箇月後病情進展組有12例(30.0％)好轉,明顯低于病情非進展組的28例(54.9％)(x2=5.64,P=0.018).結論 糖尿病、高脂血癥可能是進展性AchA腦梗死的重要影響因素.進展性AchA腦梗死可能存在明顯的頸內動脈或大腦中動脈中重度狹窄-閉塞病變,其預後差、複髮率高.
목적 탐토진전성맥락막전동맥(AchA)공혈구신발뇌경사적가능궤제이급예후.방법 련속성전첨성분석96례국한우AchA공혈구신발뇌경사환자,근거입원후1주내미국국립위생연구원졸중량표(NIHSS)평분장환자분위2조:병정진전조(42례)화병정비진전조(54례).소유환자균진행경동맥혈관초성、두부CT혈관조영(CTA)혹자공진혈관조영(MRA)등검사.비교2조환자경동맥죽양경화화혈관협착정도적차별.수방3개월,비교2조환자적예후.결과 소유국한우AchA공혈구뇌경사환자중균이고혈압위특정,재병정진전조기당뇨병병사、고지혈증구성비[35.7％ (15/42)、59.5％(25/42)]명현고우병정비진전조[14.8％ (8/54)、37.0％ (20/54)].병정진전조공검출불은정반괴71.4％(30례),명현고우병정비진전조38.9％(21례)(x2=4.42,P=0.036).병정진전조유혈관협착비례78.6％(33례)명현고우병정비진전조57.4％(31례)(x2=4.76,P=0.029).기중병정진전조동측경내동맥혹대뇌중동맥협착솔64.3％(27례)명현고우병정비진전조38.9％(21례)(x2=6.10,P=0.014).병차병정진전조동측경내동맥혹대뇌중동맥중중도협착-폐새적비솔(47.6％,20례)명현고우병정비진전조(16.7％,9례)(x2=4.81,P =0.028).수방3개월후병정진전조유12례(30.0％)호전,명현저우병정비진전조적28례(54.9％)(x2=5.64,P=0.018).결론 당뇨병、고지혈증가능시진전성AchA뇌경사적중요영향인소.진전성AchA뇌경사가능존재명현적경내동맥혹대뇌중동맥중중도협착-폐새병변,기예후차、복발솔고.
Objective To observe patients with acute ischemic infarct in the anterior choroidal artery (AchA) territory and to investigate stroke evolution in patients with AchA infarction.Methods A prospective series of 96 patients with acute iscbemic lesion in the AchA territory.Within 1 week of admission,according to national institute of health stroke scale (NIHSS) score a total of 96 patients were divided into two groups:neurological deterioration group (group A,42 cases) and no deterioration groups (group B,54 cases).All patients underwent doppler ultrasonography of the cervical arteries,computed tomography angiography or magnetic resonance angiography.Two groups were compared regarding carotid atherosclerosis and vascular stenosis.Results In patients of AchA territory,the two groups were characterized by hypertension.The constituent ratio of diabetes and hyperlipidemia in group A [35.7％ (15/42),59.5％ (25/42)] was higher than that in group B [14.8％ (8/54),37.0％ (20/54)].There were 30 cases (71.4％)with unstable plaque in group A,significantly more than that in group B [21 (38.9％)] (x2 =4.42,P =0.036).The proportions of cerebrovascular steno-occlusion in group A (33 cases,78.6％) was significantly higher than that in group B(31 cases,57.4％) (x2 =4.76,P =0.029).27 patients of group A with ipsilateral internal carotid artery(ICA) and/or middle cerebral artery(MCA) steno-occlusion (64.3％) were significantly more than those in group B (x2 =6.10,P =0.014).After 3 months 12 patients (30.0％) in group A had improvement,which was much lower than that (28 cases,54.9％) in group B(x2 =5.64,P =0.01 8).Conclusion Diabetes and hyperlipidemia may be the important factors affecting the progress of AChA infarcts.
