非大动脉粥样硬化型脑梗死155例临床分析

发布时间：2018-04-27 04:11

本文选题：非大动脉粥样硬化型脑梗死 + TOAST分型　；参考：《宁夏医科大学》2017年硕士论文

【摘要】：目的分析非大动脉粥样硬化型脑梗死的病因和危险因素、神经功能缺损情况、影像学检查、治疗及预后。方法连续收集非大动脉粥样硬化型脑梗死患者155例,按照TOAST分型标准进行病因分型并分析其临床特点。结果本研究共纳入155例患者(男性99例,女性56例)。本组患者TOAST分型的结果是:小动脉闭塞型97例(62.6%),心源性栓塞型26例(16.8%),不明原因型20例(12.9%),其他明确病因型12例(7.7%)。本组患者的危险因素为:高血压病(96例,61.9%)、高同型半胱氨酸血症(65例,41.9%)、吸烟(56例,36.1%)、糖尿病(51例,32.9%)、高脂血症(49例,31.6%)。高血压病(74.2%,?2=18.106,P0.01)和高脂血症(40.2%,?2=10.818,P0.05)的发生率在小动脉闭塞型中显著增高。小动脉闭塞型入院时神经功能缺损评分最低(2.93±2.40),心源性栓塞型入院时神经功能缺损评分最高(7.58±4.74)(?2=21.797,P0.05)。心源性栓塞型ESRS平均评分分别大于其他明确病因型和不明原因型(F=4.134,P0.05,P0.05),小动脉闭塞型ESRS平均评分分别大于其他明确病因型和不明原因型(F=4.134,P0.05,P0.05)。结论在非大动脉粥样硬化型脑梗死中小动脉闭塞型所占比例最高,其他明确病因型所占比例最低。心源性栓塞型脑梗死好发于中年、老年患者,而其他明确病因型好发于青年患者。高血压病或高脂血症在小动脉闭塞型脑梗死中更显著。小动脉闭塞型脑梗死患者入院时神经功能缺损最轻,心源性栓塞型脑梗死患者入院时神经功能缺损最重。非大动脉粥样硬化型脑梗死病因复杂多样,各亚型的临床特点存在较大差异,临床上需要根据不同病因予以个体化医疗支持及评估预后。
[Abstract]:Objective to analyze the etiology and risk factors, neurological deficit, imaging examination, treatment and prognosis of non-arteriosclerotic cerebral infarction. Methods 155 patients with non-arteriosclerotic cerebral infarction were collected and analyzed according to TOAST classification criteria. Results 155 patients (99 males and 56 females) were included in this study. The results of TOAST classification were as follows: small artery occlusion in 97 cases, cardiogenic embolism type in 26 cases, cardiac embolism type in 26 cases, unknown cause type in 20 cases, and other definite etiological type in 12 cases. The risk factors were as follows: 96 cases of hypertension, 65 cases of hyperhomocysteinemia and 41.9%, 56 cases of smoking, 51 cases of diabetes mellitus, 51 cases of diabetes mellitus, 49 cases of hyperlipidemia and 49 cases of hyperlipidemia. The incidence of hypertension (74.2) and hyperlipidemia (40.22) and hyperlipidemia (40.22) were significantly higher in the arteriole occlusion type. The neurological deficit score of arteriole occlusion type was the lowest (2.93 卤2.40) on admission, and that of cardiac embolism type was the highest (7.58 卤4.74) on admission (P 0.05). The average score of ESRS of cardiac embolism type was higher than that of other definite etiology type and unknown cause type, respectively. The mean score of small artery occlusion type ESRS was higher than that of other definite etiological type and unknown cause type (P 0.05 P 0.05) respectively, and the mean score of small artery occlusion type was higher than that of other definite etiological type and unknown cause type. Conclusion the proportion of arteriole occlusion is the highest in non-arteriosclerosis cerebral infarction and the lowest in other definite etiological types. Cardiogenic embolism cerebral infarction is more common in middle-aged and elderly patients, while other definite etiological types are more common in young patients. Hypertension or hyperlipidemia is more significant in arterio-occlusive cerebral infarction. The patients with arteriolar occlusive cerebral infarction had the lightest neurological deficit at admission, and the patients with cardiogenic embolism cerebral infarction had the most severe neurological impairment at admission. The etiology of non-arteriosclerotic cerebral infarction is complex and diverse, and the clinical characteristics of each subtype are quite different. Therefore, individualized medical support should be given according to the different causes and the prognosis should be evaluated.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.3

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