大脑后动脉区梗死与后循环血管状态及危险因素关系

发布时间：2018-06-29 06:34

本文选题：脑梗死 + 大脑后动脉区　；参考：《中风与神经疾病杂志》2017年08期

【摘要】：目的探讨大脑后动脉区梗死与后循环血管状态及危险因素的关系。方法回顾性收集2010年1月-2014年6月在首都医科大学宣武医院神经内科住院的经头部MRI证实的首次新发大脑后动脉区梗死的患者192例,其中171例行CT血管成像,21例行DSA,排除有可疑心源性栓子来源的患者。根据头部MRI将梗死部位分为A(中脑组)、B(丘脑组)、C(颞叶内侧组)、D(胼胝体压部组)、E(枕叶组)、F(多部位梗死组)6组。比较PCA区梗死与后循环血管状态及危险因素的关系。结果 (1)PCA区梗死病变分布:192例患者中A、B、C、D、E、F组分别为12例(6.3%)、74例(38.5%)、15例(7.8%)、11例(5.7%)、28例(14.6%)、52例(27.1%)。(2)椎-基底动脉系统血管状态:椎动脉病变66例(34.4%)合并大脑后动脉狭窄13例,基底动脉病变27例(14.1%)合并大脑后动脉狭窄2例,大脑后动脉病变45例(23.4%),未发现血管病变69例(35.9%)。(3)对PCA区梗死病变分布与后循环血管病变行单因素卡方检验:B组与基底动脉病变相关(χ~2=5.318,P=0.021);E组与PCA P4段病变相关(χ~2=18.556,P0.001);F组与椎动脉、基底动脉病变相关(χ~2=4.386,7.059;P=0.036,0.008)。(4)血管病变组与无血管病变组比较:合并高血压病差异有统计学意义(11.126,P=0.001)。结论大脑后动脉区梗死与后循环血管病变关系密切,尤其合并导致血管病变的危险因素时,更应重视血管检查,减少卒中再发。
[Abstract]:Objective to investigate the relationship between posterior cerebral artery infarction and vascular status and risk factors of posterior cerebral circulation. Methods 192 patients who were admitted to the Department of Neurology, Xuanwu Hospital, Capital Medical University from January 2010 to June 2014, who were confirmed by head MRI for the first time in the posterior cerebral artery area, were retrospectively collected. Of these 171 patients were treated with CT angiography and 21 patients with DSA.The patients with suspected cardiogenic emboli were excluded. According to head MRI, the infarct was divided into 6 groups: group A (midbrain group), group B (thalamus group), group C (medial temporal lobe group), group D (corpus callosum bulbar group), group E (occipital lobe group) and group F (multi-site infarction group). To compare the relationship between PCA area infarction and posterior circulation vascular status and risk factors. Results (1) there were 12 cases (6.3%) in group A (6.3%), 74 cases (38.5%) in group A, 15 cases (7.8%) in group A (7.5%), 11 cases (5.7%), 28 cases (14.6%), and 52 cases (27.1%). (2) in). (_ 2: vertebral artery lesions in 66 cases (34.4%) complicated with posterior cerebral artery stenosis in 13 cases. There were 27 cases (14.1%) with basilar artery disease and 2 cases with posterior cerebral artery stenosis. In 45 cases (23.4%) of posterior cerebral artery lesions, 69 cases (35.9%) were found no vascular lesions. One-factor chi-square test was performed to examine the distribution of infarct lesions and posterior circulation vascular lesions in). (area (蠂 ~ 2 / 2 ~ (2) B group and basilar artery disease (蠂 ~ (2 +) ~ (2) ~ (2) ~ (18) 18 ~ (18) ~ (P0. 01) P ~ (0.021) Group E was associated with P4 segment lesions (蠂 ~ (2 +) ~ (18.556) P ~ (0.001) and vertebral artery in Group F (P ~ (0.001). There was a significant difference between the vascular lesion group and the non-vascular lesion group (11.126% P0. 001) in the patients with basilar artery disease (蠂 2 + 4.386 ~ 7.059) P0.036 ~ 0.008). (_ 4 (蠂 ~ (2 / 2), and there was a significant difference between the vascular lesion group and the non-vascular lesion group (11.126% P0. 001). Conclusion there is a close relationship between posterior cerebral artery infarction and posterior circulation vascular disease, especially when complicated with the risk factors of vascular disease, more attention should be paid to vascular examination to reduce the recurrence of stroke.
【作者单位】：首都医科大学宣武医院神经内科;北京市第一中西医结合医院神经内科;首都医科大学宣武医院放射科;
【分类号】：R743.3

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