不伴基底动脉狭窄的脑桥旁正中梗死部位与发病机制的关系

发布时间：2018-04-30 00:14

本文选题：脑桥旁正中梗死 + 动脉粥样硬化　；参考：《中风与神经疾病杂志》2017年09期

【摘要】：目的探讨不伴基底动脉狭窄的脑桥旁正中梗死(PPI-BAS)部位与发病机制的关系。方法回顾性分析脑桥旁正中梗死(PPI)患者150例,将PPI-BAS按梗死部位分为累及脑桥腹侧表面组(vPPI-BAS)及未累及脑桥腹侧表面组(dPPI-BAS),以伴基底动脉狭窄的脑桥旁正中梗死(PPI+BAS)为对照,比较其年龄、性别、吸烟、饮酒、高脂血症、高同型半胱氨酸血症、冠心病、糖尿病、颅内颈内动脉系狭窄(ICAS)、颅外动脉粥样硬化(EAAS)、基底动脉高信号、梗死灶层面数≥2层、早期神经功能恶化(END)、高血压、腔隙性脑梗死(LI)和脑白质疏松(LA)是否有差异。结果 150例患者中dPPI-BAS组41例(27.3%),vPPI-BAS组65例(43.3%),PPI+BAS组44例(29.3%),三组之间年龄、性别、吸烟、饮酒、高脂血症、高同型半胱氨酸血症差异无统计学意义(P0.05),三组之间冠心病、糖尿病、高血压、LA分级、LI分级、ICAS、EAAS、基底动脉高信号、梗死灶层面数≥2层及END的差异有统计学差异(P0.05)。vPPI-BAS组与PPI+BAS组各因素之间差异均无统计学差异(P0.05)。与PPI+BAS组比较,dPPI-BAS组冠心病、糖尿病、ICAS、EAAS、基底动脉高信号、梗死灶层面数≥2和END的发生率低,而高血压、LA、LI的发生率高(P0.05)。vPPI-BAS组与dPPI-BAS组比较,vPPI-BAS组ICAS、EAAS、梗死灶层面数≥2层和END发生率高,dPPI-BAS组高血压、LA和LI发生率高(P0.05)。多因素logistic回归分析结果显示:LA分级是dPPI-BAS的独立危险因素。结论 vPPI-BAS多由动脉粥样硬化机制引起,dPPI-BAS多由小血管病机制引起。
[Abstract]:Objective to investigate the relationship between para pontine median infarction (PPI-BAS) without basilar artery stenosis and pathogenesis. Methods a retrospective analysis of 150 patients with para pontine median infarction (PPI) was divided into PPI-BAS (vPPI-BAS) and uninvolved pontine ventral surface group (dPPI-BAS) according to the infarct location, with basilar artery stenosis. The median infarction (PPI+BAS) was compared to the age, sex, smoking, smoking, drinking, hyperlipidemia, hyperhomocysteinemia, coronary heart disease, diabetes, intracranial carotid artery stenosis (ICAS), cranial atherosclerosis (EAAS), high basilar artery number, the number of infarcts more than 2 layers, early neurological deterioration (END), hypertension, and lacunar. Whether there were differences in cerebral infarction (LI) and leukoaraiosis (LA). Results of 150 patients, 41 cases (27.3%), 65 cases (43.3%), 44 cases (29.3%) in group PPI+BAS, three groups of age, sex, smoking, drinking, hyperlipidemia, and hyperhomocysteinemia were not statistically significant (P0.05), between the three groups, coronary heart disease, diabetes, and high blood between the three groups. Pressure, LA classification, LI classification, ICAS, EAAS, high signal of basilar artery, the number of infarcts more than 2 layers and END were statistically different (P0.05) there was no statistical difference between the.VPPI-BAS group and the PPI+BAS group (P0.05). Compared with the PPI+BAS group, the dPPI-BAS group was crowns, diabetes, the basilar artery high signal, and the infarct level more than 2. The incidence of END and END was low, and the incidence of hypertension, LA, and LI was high (P0.05) in group.VPPI-BAS, and in group vPPI-BAS, the number of ICAS, EAAS, the number of infarcts more than 2 layers and END, dPPI-BAS group hypertension and higher incidence of LA and END. PPI-BAS is mostly caused by atherosclerosis, and dPPI-BAS is mostly caused by the mechanism of small vessel disease.

【作者单位】：辽宁省人民医院神经内科;大连医科大学神经病学系;
【分类号】：R743.33

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