两种不同类型单侧孤立脑桥梗死发病机制

发布时间：2018-07-03 17:03

本文选题：脑桥 + 脑梗死　；参考：《解放军医药杂志》2016年04期

【摘要】：目的探讨脑桥旁正中梗死(PPI)和脑桥深部梗死(SDPI)的可能发病机制。方法选择2012年10月—2016年2月收治的急性脑桥梗死90例,其中PPI 58例,SDPI 32例。对两组进行影像学检查,比较两组基底动脉狭窄程度、基底动脉粥样硬化斑块和脑微出血发生情况。结果 PPI组女性比例明显高于SDPI组(P0.05);PPI合并糖尿病史的比例高于SDPI组(P0.05)。PPI组总胆固醇、低密度脂蛋白胆固醇、纤维蛋白原及美国国立卫生院神经功能缺损量表(NIHSS)评分均高于SDPI组(P0.05)。PPI组基底动脉斑块发生率高于SDPI组,梗死灶最大直径大于SDPI组(P0.01)。两组基底动脉狭窄程度比较差异无统计学意义(P0.05)。两组脑深部、幕下区域微出血分级比较差异有统计学意义(P0.05)。结论 PPI发病机制可能为主要基底动脉分支口病变,其次为大动脉粥样硬化改变,而SDPI发病机制考虑为小穿支动脉闭塞。
[Abstract]:Objective to investigate the possible pathogenesis of parafontine median infarction (PPI) and deep pontine infarction (SDPI). Methods from October 2012 to February 2016, 90 patients with acute pons infarction were selected, including 58 patients with PPI and 32 patients with SDPI. The degree of basilar artery stenosis, atherosclerotic plaque and cerebral microhemorrhage were compared between the two groups. Results the proportion of women in PPI group was significantly higher than that in SDPI group (P0.05) and the proportion of PPI complicated with diabetes history was higher than that in SDPI group (P0.05) .Total cholesterol and low density lipoprotein cholesterol (LDL-C) in PPI group. Fibrinogen and NIHSS score were higher than those in SDPI group (P0.05). The incidence of basilar artery plaque in PPI group was higher than that in SDPI group, and the maximum diameter of infarct was larger than that in SDPI group (P0.01). There was no significant difference in the degree of basilar artery stenosis between the two groups (P0.05). There was significant difference between the two groups in the classification of microhemorrhage in deep brain and subtentorial region (P0.05). Conclusion the pathogenesis of PPI may be the main branch of the basilar artery, followed by the changes of atherosclerosis, while the pathogenesis of SDPI is considered to be perforating artery occlusion.
【作者单位】：锦州医科大学研究生学院;沈阳军区总医院神经内科;
【基金】：辽宁省科技攻关计划(2011225021,2013225089)
【分类号】：R743.33

【相似文献】