不同分型分水岭脑梗死的CT脑灌注表现及其临床相关性

发布时间：2018-03-07 04:12

本文选题：分水岭脑梗死　切入点：脑血流动力学　出处：《实用医学杂志》2017年07期 　论文类型：期刊论文

【摘要】：目的:探讨不同分型分水岭脑梗死的脑血流动力学特点及其临床的相关性。方法:收集2013年1月至2016年5月在我院因急性缺血性脑卒中入院行CT脑灌注检查,选择核磁共振DWI证实分水岭脑梗死患者34例,包括皮层分水岭脑梗死(CWSI)15例,内分水岭脑梗死(IWSI)19例,比较两组患者的影像学特点及临床资料。结果:CT脑灌注显示18例在分水岭梗死区周围出现异常低灌注,与对侧比较脑血流量(CBF)减低、平均通过时间(MTT)及峰值时间(TTP)延迟,脑血容量(CBV)无变化。有异常低灌注组有10例于入院第1周病情出现恶化,无异常低灌注组仅有2例,两者有统计学差异(χ~2=6.88,P0.01)。IWSI组有13例患者出现异常低灌注,CWSI组有5例,差异有统计学意义(χ~2=4.14,P0.05)。IWSI组有7例预后不良,CWSI组只有1例,差异有统计学意义(χ~2=4.24,P0.05)。结论:低灌注是IWSI重要的诱发因素且与预后有关,IWSI较CSWI预后差。X
[Abstract]:Objective: to investigate the characteristics of cerebral hemodynamics and its clinical correlation in patients with acute ischemic stroke from January 2013 to May 2016. Methods: Ct perfusion examination was performed in our hospital from January 2013 to May 2016 for acute ischemic stroke. Thirty-four patients with watershed cerebral infarction confirmed by DWI were selected, including 15 patients with cortical watershed cerebral infarction and 19 patients with internal watershed cerebral infarction. Results 18 cases of cerebral perfusion showed abnormal hypoperfusion around the watershed infarct area, and CBFs decreased, mean transit time (MTT) and peak time (TTP) were delayed, compared with the contralateral group, the imaging features and clinical data of the two groups were compared. There was no change in CBV of cerebral blood volume. In the group with abnormal low perfusion, the condition deteriorated in the first week of admission, and only 2 cases in the group without abnormal low perfusion. There was a significant difference between the two groups (蠂 2 + 6.88 P 0.01G. IWSI group, 13 cases with abnormal hypoperfusion CWSI group, 5 cases with CWSI group). The difference was statistically significant (蠂 ~ 2 / 2 ~ (4.14) P _ (0.05) P ~ (0.05)). There was only 1 case of poor prognosis in CWSI group (蠂 ~ (2 +) 2.24% P 0.05). Conclusion: low perfusion is an important inducing factor of IWSI and is associated with poor prognosis of IWSI compared with that of CSWI. [WT5 "HZ] [WT5BZ] the prognosis of IWSI is worse than that of CSWI.
【作者单位】：广东省佛山市顺德区第二人民医院;
【基金】：广东省佛山市医学类科技攻关项目(编号:2014AB002353)
【分类号】：R743.3

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