责任性颅内动脉粥样硬化性狭窄致首发缺血性脑卒中解剖模式与发病机制的关系

发布时间：2019-05-13 20:15

【摘要】：目的探讨责任性颅内动脉粥样硬化性狭窄(Intracranial atherosclerotic stenosis,ICAS)致首发缺血性脑卒中(Ischemic stroke,IS)解剖模式与发病机制的关系。方法回顾性分析261例责任性ICAS致首发IS患者的临床资料。根据弥散加权成像(DWI)的影像学表现分为单发病灶(皮质-皮质下梗死、皮质梗死、皮质下梗死),弥散病灶,多发病灶(单侧前循环或后循环多发梗死);卒中机制分为动脉到动脉栓塞、原位血栓形成、穿支动脉闭塞、低灌注、多发机制等。结果单发皮质下梗死是责任性ICAS致首发IS最常见的卒中模式(41.38%,108/261);责任性ICAS致IS主要发病机制为穿支动脉闭塞(41.38%,108/261);责任性ICAS致IS的解剖模式与发病机制显著相关(r=0.384,P=0.001),穿支动脉闭塞与皮质下梗死相关(r=0.805,P=0.001),弥散梗死、单侧前循环多发梗死、后循环多发性梗死,分别与动脉到动脉栓塞(r=0.853,P=0.001;r=0.860,P=0.001;r=0.281,P=0.001)、及多发机制(r=0.792,P=0.001;r=0.883,P=0.001;r=0.213,P=0.001)相关。结论卒中解剖模式有助于明确责任性ICAS致缺血性脑卒中的发病机制,有利于指导其临床诊治及预防措施的拟定。
[Abstract]:Objective to investigate the relationship between anatomical pattern and pathogenesis of primary ischemic stroke (Ischemic stroke,IS) caused by responsible intracranial atherosclerotic stenosis (Intracranial atherosclerotic stenosis,ICAS). Methods the clinical data of 261patients with IS caused by responsible ICAS were analyzed retrospectively. According to the imaging findings of diffusion-weighted imaging (DWI), they were divided into single focus (subcortical infarction, subcortical infarction), diffusion focus and multiple focus (unilateral anterior circulation or posterior circulation multiple infarction). The mechanism of stroke can be divided into artery to artery embolism, thrombosis in situ, occlusion of perforator artery, hypoperfusion, multiple mechanism and so on. Results single subcortical infarction was the most common stroke pattern of IS caused by responsible ICAS (41.38%, 108%), and the main pathogenesis of IS caused by responsible ICAS was perforating artery occlusion (41.38%, 108%). The anatomical pattern of IS induced by responsible ICAS was significantly correlated with the pathogenesis (r 鈮，

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