516例缺血性小卒中患者SSS-TOAST分型结果及颅内梗死灶分析

发布时间：2018-05-04 05:06

  本文选题：脑梗死 + 缺血性小卒中　； 参考：《山东医药》2017年27期

【摘要】：目的观察516例缺血性小卒中患者的SSS-TOAST分型情况,并分析颅内梗死灶的特点。方法缺血性小卒中患者516例,进行SSS-TOAST分型,观察颅内梗死灶情况。收集患者年龄、Essen卒中风险分层量表(ESRS)评分、90 d改良Rankin量表(mRS)评分、头颅核磁共振成像(MRI)+磁共振血管成像(MRA)+弥散加权成像(DWI)、颈部血管检查等资料,并在不同SSS-TOAST分型间进行比较。结果 516例缺血性小卒中患者SSSTOAST分型为大动脉粥样硬化型174例(33.72%)、心源性脑栓塞型39例(7.56%)、小动脉闭塞型229例(44.38%)、其他原因11例(2.13%)、原因不明63例(12.21%),主要类型为大动脉粥样硬化型和小动脉闭塞型,其中大动脉粥样硬化型患者大动脉狭窄、90 d mRS评分预后不良发生率高于小动脉闭塞型(P均0.05)。357例(69.19%)颅内梗死灶为孤立性病灶,其中231例(64.71%)病灶在皮层下、深部白质、基底节等常见位置;159例(30.81%)为多发病灶。282例(54.65%)患者颅内梗死灶直径(或之和)20 mm,234例(45.35%)直径(或之和)≥20 mm。本组缺血性小卒中患者颅内梗死灶多为孤立性病灶,多数病灶大小20 mm,孤立性病灶多位于常见位置(P均0.05)。结论缺血性小卒中患者SSS-TOAST分型多为大动脉粥样硬化型和小动脉闭塞型,前者合并大动脉狭窄和预后不良比例更高;缺血性小卒中患者颅内梗死灶多为常见位置的孤立性病灶,但部分患者颅内梗死灶直径≥20 mm,多发梗死灶者也占一定比例。
[Abstract]:Objective to observe the SSS-TOAST classification of 516 patients with ischemic stroke and analyze the characteristics of intracranial infarction. Methods SSS-TOAST classification was performed in 516 patients with ischemic stroke. The age of patients with stroke risk stratification scale (ESRS) was evaluated with the modified Rankin scale (90 d), the cranial magnetic resonance imaging (MRI), diffusion weighted imaging (DWI) and cervical vascular examination (DWI). The data were compared among different SSS-TOAST types. Results the SSSTOAST classification of 516 patients with ischemic stroke was as follows: large artery atherosclerotic type 174 cases, cardiogenic cerebral embolism type 39 cases, arteriole occlusion type 229 cases, small artery occlusion type 229 cases, other reasons 2.13%, and unknown reason 63 cases, the main type was large artery porridge. Like sclerosing and arteriolar occlusion, The incidence of poor prognosis in patients with arteriosclerotic arteriosclerosis was higher than that in patients with arteriole occlusion (P = 0.05, P = 0.050.357).) Intracranial infarctions were solitary lesions, of which 231 cases were located in the subcortical and deep white matter, among them, 64.71% of the lesions were located in the subcortical and deep white matter. The diameter (or sum) of the intracranial infarct was more than 20 mm. in 234 patients (or the sum of 20 mm), the diameter (or sum) of the infarct was more than 20 mm. in 159 cases of basal ganglia and 30.81% of the lesions, the diameter (or sum) of the infarct was more than 20 mm. in the patients with multiple lesions, the diameter of the infarct was more than 20 mm. Most of the cerebral infarcts in this group were solitary lesions, most of which were 20 mm in size, and most of the solitary lesions were located in common locations (P < 0.05). Conclusion the SSS-TOAST classification of ischemic stroke patients is mostly arteriosclerotic type and arterio-occlusive type, the former has a higher proportion of arterial stenosis and poor prognosis, and the intracranial infarction focus of ischemic stroke patients is mostly solitary lesions in common location. But in some patients, the diameter of cerebral infarction was 鈮，

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