不同类型腔隙性脑梗死发病机制的探讨

发布时间：2018-06-23 08:26

本文选题：脑梗死 + 动脉粥样硬化　；参考：《中华老年心脑血管病杂志》2016年09期

【摘要】：目的通过比较不同类型腔隙性脑梗死(lacunar infarction,LI)与非LI的危险因素,推测其发病机制。方法回顾性分析2008年8月1日~2014年12月13日入住我院的急性颈内动脉系统脑梗死患者的临床资料,根据临床表现及影像学结果筛选出符合入选标准的患者LI 148例和非LI 148例。根据头颅MRI弥散加权成像上病灶数目及位置分为单发LI 113例,多发LI 35例;单发非LI 97例,多发非LI 51例。采用logistic回归分析IL的危险因素。结果单发LI的心房颤动及同侧颈动脉狭窄≥50%的发生率较多发LI(0.88%vs 11.43%,P=0.013;1.77%vs 17.14%,P=0.002)、单发非LI(0.88%vs 11.34%,P=0.001;1.77%vs 16.49%,P=0.000)、多发非LI(0.88%vs 9.80%,P=0.018;1.77%vs 17.65%,P=0.000)明显低。与单发LI比较,心房颤动及同侧颈动脉狭窄≥50%为多发LI(OR=26.353,95%CI:2.778~250.007,P=0.011;OR=11.483,95%CI:2.202~59.891,P=0.011)、单发非IL及多发非IL的独立危险因素。多发LI与单发非IL和多发非LI心房颤动及同侧动脉狭窄≥50%等危险因素无差异(P0.05)。结论单发LI与多发LI具有不同的发病机制,推测动脉粥样硬化病变及心源性栓塞为多发性LI的重要发病机制,但参与单发LI发病过程的概率相对较少。
[Abstract]:Objective to speculate on the pathogenesis of different types of lacunar infarction (lacunar infarction, LI) and non LI. Methods the clinical data of acute cerebral infarction in the internal carotid artery system in our hospital in December 13th, August 1, 2008, were retrospectively analyzed. According to the clinical and imaging results, the clinical data were selected and selected to be selected. Standard patient LI 148 cases and non LI 148 cases. According to the number and position of MRI diffusion weighted imaging, 113 cases of single LI, 35 cases of multiple LI, single non LI 97 cases, and multiple non LI 51 cases. The risk factors of IL were analyzed by logistic regression. The results showed that the incidence of atrial fibrillation in single LI and the incidence of equal carotid stenosis more than 50% was LI (0.) 88%vs 11.43%, P=0.013; 1.77%vs 17.14%, P=0.002), the single hair was not LI (0.88%vs 11.34%, P=0.001; 1.77%vs 16.49%, P=0.000), and the multiple non LI (0.88%vs 9.80%, P=0.018; 17.65%) was significantly lower. 202~59.891, P=0.011), single occurrence of non IL and multiple non IL independent risk factors. There was no difference in the risk factors of multiple LI and single non IL and multiple non LI atrial fibrillation and equal artery stenosis more than 50% (P0.05). Conclusion single LI and multiple LI have different pathogenesis. It is concluded that atherosclerotic lesions and cardiogenic embolism are important for multiple LI. Pathogenesis, but the probability of involvement in the pathogenesis of single LI is relatively small.
【作者单位】：江苏省苏北人民医院神经内科;
【分类号】：R743.3

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