首次脑梗死患者中静止性脑梗死的影像学特点及危险因素分析

发布时间：2018-06-19 06:03

本文选题：脑梗死 + 静止性脑梗死　；参考：《青岛大学》2013年硕士论文

【摘要】：目的：研究首次急性脑梗死合并静止性脑梗死患者中,静止性梗死病灶的影像学特点及相关危险因素,探讨其可能的病因和发病机制。方法：选择住院的首次急性脑梗死患者196例,通过颅脑MRI及相关血管检查,分为首次脑梗死合并静止性脑梗死组(SBI-P)88例和首次脑梗死无静止性脑梗死组(SBI-N)108例,总结SBI病灶的影像学特点,比较两组的血管性危险因素和脑白质病变的比例,并比较在TOAST分型中,不同类型的脑梗死患者SBI的发生率。结果：首次脑梗死合并SBI的患者共有88例,占所有首次脑梗死患者的44.9%,其中单个病灶者52例,占59.1%,多个病灶者36例,占40.9%；在单发病灶的患者中,有30例位于基底节,占57.7%；在多发病灶的患者中,有28例累及到基底节区；在所有SBI患者中累及基底节的患者共58例,占72.2%。高龄、高血压、颅脑MRI检查发现脑白质病变的患者中,SBI发生率较高(P0.05)；而其他的血管性危险因素,包括糖尿病、高脂血症、房颤、吸烟以及饮酒等与SBI的存在无明显相关性(P0.05)。在196例首发脑梗死患者中,按照TOAST分型,LAD有105例,其中存在SBI者42例,占40.0%；SVD有60例,存在SBI者37例,占61.7%,在小血管病患者中更多的存在SBI(P0.05)。结论：在症状性脑梗死患者中,SBI的发病率更高；高龄、高血压和脑白质病变与SBI的发生密切相关,是其主要的危险因素；在症状性脑梗死SVD型患者中,SBI的比例更高,提示SBI同小血管病有相似的病因和发病机制。
[Abstract]:Objective: to study the imaging features and related risk factors of the patients with acute cerebral infarction (ACI) complicated with static cerebral infarction (CI) for the first time, and to explore its possible etiology and pathogenesis. Methods: 196 inpatients with first acute cerebral infarction were divided into two groups: the first cerebral infarction with static cerebral infarction group (n = 88) and the first cerebral infarction group without static cerebral infarction group (n = 108) by craniocerebral MRI and related vascular examination. To summarize the imaging features of SBI lesions, compare the vascular risk factors and the proportion of white matter lesions between the two groups, and compare the incidence of SBI in patients with different types of cerebral infarction in toast classification. Results: there were 88 patients with first cerebral infarction complicated with SBI, accounting for 44.9 percent of all the patients with first cerebral infarction, 52 patients with a single lesion (59.1%), 36 patients with multiple lesions (40.9%), 30 patients with a single lesion in basal ganglia (57.7%). Among the patients with multiple lesions, 28 cases were involved in basal ganglia and 58 cases (72.2%) were involved in basal ganglia in all SBI patients. The incidence of SBI was higher in the elderly, hypertension, brain MRI patients with leukoencephalopathy, while other vascular risk factors, including diabetes mellitus, hyperlipidemia, atrial fibrillation, smoking and alcohol consumption, had no significant correlation with SBI. Among 196 patients with initial cerebral infarction, 105 cases were diagnosed as lad according to the toast classification, among which 42 cases had SBI, 60 cases had SVD and 37 cases had SBI, accounting for 61.7%. Conclusion: the incidence of SBI is higher in patients with symptomatic cerebral infarction, high age, hypertension and leukoencephalopathy are the main risk factors of SBI, and the proportion of SBI in SVD patients with symptomatic cerebral infarction is higher than that in patients with symptomatic cerebral infarction. It suggests that SBI has similar etiology and pathogenesis with small vascular disease.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R743.33

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