大脑中动脉供血区进展性卒中影像分型、MRA表现与中风病证候分布的相关性研究

发布时间：2019-01-10 20:34

【摘要】：目的:探讨大脑中动脉（MCA）供血区进展性缺血性卒中影像类型、脑血管病变特点和中医证候要素间的内在联系，以期为MCA供血区进展性卒中的防治提供依据。方法:选取我院脑病科MCA供血区进展性缺血性卒中住院患者128例,收集相关资料，根据磁共振DWI序列表现将患者分为区域梗死、皮质下梗死、边缘带梗死、弥散小梗死4种类型；根据缺血性中风证候要素诊断量表，，以风、火、痰、气虚、血瘀、阴虚6大要素判定证候，就患者一般资料、梗死类型、证候特点和相应MRA表现作出统计学分析。结果:MCA供血区进展性缺血性卒中多在起病3天神经功能缺损达高峰；大血管病变普遍；影像梗死类型以边缘带梗死发生率最高（53.1%），其血管病变以MCA重度狭窄和多支血管病变为主（73.85%）；中风证候以风、气虚、血瘀为主；六种证候中唯有气虚与梗死类型相关，以边缘带梗死为主；也仅有气虚证与血管病变程度有一定相关性；包含气虚血瘀的多证组合（气虚-血瘀、气虚－血瘀－痰湿与气虚－血瘀－阴虚）是MCA供血区进展性卒中主要的证候组合形式。结论：MCA供血区进展性卒中以MCA狭窄及多支血管狭窄引起的边缘带梗死为主。中医证候要素以风、气虚、血瘀多见，其中惟有气虚与MCA严重狭窄、多支血管狭窄和边缘带梗死相关。包含气虚血瘀的多证组合是MCA供血区进展性卒中主要的证候组合形式。
[Abstract]:Objective: to explore the image types of progressive ischemic stroke in (MCA) supply area of middle cerebral artery (MCAA), the characteristics of cerebrovascular disease and TCM syndromes in order to provide evidence for the prevention and treatment of progressive stroke in MCA supply area. Methods: 128 patients with progressive ischemic stroke in MCA blood supply area in our department of encephalopathy were selected, and the relevant data were collected. According to the DWI sequence list, the patients were divided into regional infarction, subcortical infarction and marginal zone infarction. 4 types of diffuse small infarction; According to the diagnostic scale of syndromes of ischemic stroke, six factors, wind, fire, phlegm, qi deficiency, blood stasis and yin deficiency, were used to determine the syndromes. The general data, infarction type, syndrome characteristics and corresponding MRA manifestations were analyzed statistically. Results: progressive ischemic stroke in the MCA blood supply area reached the peak on the 3rd day after onset of the disease, and the major vascular lesions were common. The incidence of infarction in the marginal zone was the highest (53.1%), the main vascular lesions were severe stenosis of MCA and multi-vessel disease (73.85%), the syndrome of apoplexy was wind, deficiency of qi and blood stasis. Among the six syndromes, only deficiency of qi was related to the type of infarction, mainly in marginal zone, and there was only a certain correlation between deficiency of qi and degree of vascular lesion. Multiple syndromes including qi deficiency and blood stasis (qi deficiency-blood stasis, qi deficiency-blood stasis-phlegm dampness and qi deficiency-blood stasis-yin deficiency) are the main syndromes of progressive stroke in MCA blood supply area. Conclusion: the main type of progressive stroke in MCA feeding area is the marginal zone infarction caused by MCA stenosis and multiple vessel stenosis. Syndrome elements of TCM are wind, qi deficiency and blood stasis, among which qi deficiency is associated with severe stenosis of MCA, stenosis of multiple vessels and infarction of marginal zone. Multiple syndromes including qi deficiency and blood stasis are the main syndromes of progressive stroke in MCA blood supply area.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3

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