不同动脉病变导致的皮质下小的梗死的临床特点分析  

Analysis of clinic features of small subcortical infarction with different etiologies

作　　者：李兰玉[1] 李焰生[1] 

机构地区：[1]上海交通大学医学院附属仁济医院神经内科,上海200127

出　　处：《神经病学与神经康复学杂志》2011年第2期57-60,共4页Journal of Neurology and Neurorehabilitation

摘　　要：目的探讨不同病因导致的皮质下小的梗死(SSI)的临床特点。方法收集连续住院的SSI患者118例,据急性缺血性脑卒中病因分型SSS-TOAST诊断标准分为动脉粥样硬化性组(大动脉组)和小动脉病变组(小动脉组)。应用美国国立卫生院神经功能缺损评分(NIHSS)评分对所有患者的神经系统缺损程度评价。按照临床表现,分为纯运动性卒中、纯感觉性卒中、感觉运动性卒中、构音障碍、共济失调轻偏瘫、面舌综合征、构音障碍-面轻瘫综合征,无症状性及混合型等。结果 118例患者中,大动脉组26例、小动脉组75例。大动脉组患者NIHSS评分为(5.15±3.62)分,小动脉病变组为(3.97±2.87)分,两组间评分差异无显著统计学意义(P=0.175)。SSI的临床表现以各种不典型综合征为表现的混合型最多见,其次为构音障碍-面轻瘫综合征。不同病因组间在临床表现上的差异无显著统计学意义(P=0.283)。结论动脉粥样硬化性和小动脉病变性SSI的临床特点无显著差异。Objective To analyze the clinic features of small subcortical infarction(SSI) with different etiologies.Methods One hundred and eighteen continuous hospitalized acute SSI patients were enrolled and were classified according to the Stop Stroke Trial of Org 10 172 in Acute Stroke Treatment Classification System(SSS-TOAST) criteria as the atherosclerosis group and the small-artery disease group.Their National Institute of Health Stroke Scale(NIHSS) scores were collected.Their clinical features were characterized as pure motor stroke,pure sensory stroke,sensorimotor stroke,dysarthria,ataxia-hemiparesis,faciolingual symptoms dysarthria-facial paresis syndrome,and mixed pattern.Results Among the 118 patients,26 were caused by atherosclerosis and 75 were caused by small-artery disease.There was no significant difference of mean scores of NIHSS between the atherosclerosis group(5.15±3.62) and small-artery disease group(3.97±2.87)(P=0.175).The commonest clinical features of two groups were the mixed pattern and dysarthria-facial paresis syndrome.Different causes in clinical features between the groups was no significant difference(P=0.283).Conclusion There was no significant difference in clinic features of SSI caused by atherosclerosis or small-artery disease.

关 键 词：皮质下小的梗死 动脉粥样硬化 小动脉病变 临床特点 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R743.9[医药卫生—临床医学]