80岁以上老年后循环脑梗死患者临床特点及预后分析  

Investigation of clinical characteristics and prognosis of elderly patients aged 80 and over with posterior circulation infarction

作　　者：刘猛[1] 盛世英[1] 张菊美[1] 吴坚[1] 

机构地区：[1]常州市第一人民医院神经内科,江苏省常州市213003

出　　处：《实用老年医学》2013年第11期927-929,共3页Practical Geriatrics

摘　　要：目的探讨≥80岁老年后循环脑梗死(PCI)的临床特点、预后以及影响预后的因素。方法回顾分析133例≥80岁的老年PCI患者的临床症状、影像学资料、发病危险因素、美国国立卫生研究院脑卒中量表(NIHSS)评分,并于发病后30 d进行改良Rankin量表(MRS)评估分析预后。结果≥80岁老年PCI最常见的危险因素是高血压(79.7%)、高脂血症(58.65%)和糖尿病(21.8%)。常见症状为肢体乏力(50.38%)、言语不清(25.56%)和头晕(14.29%)。常见梗死部位是脑桥和小脑。≥80岁老年PCI患者发病后30 d严重残障率为24.06%,病死率为4.51%,预后不良的危险因素包括高NIHSS评分和后循环远段血管受累。结论动脉粥样硬化是老年PCI患者主要的发病危险因素。老年PCI患者临床表现复杂多变且缺乏特征性症状,入院时高NIHSS评分和远段血管受累是其预后不良的影响因素。Objective To investigate the clinical characteristics and prognosis of elderly patients aged 80 and over with posterior circulation infarction( PCI). Methods A total of 133 patients aged 80 and over with PCI were enrolled in this study. The risk factors,clinical presentation,neuroradiological data,NIHSS score and the modified Rankin Scale( MRS) score after 1 month were reviewed retrospectively. Results hypertension( 79. 7%),hyperlipoidemia( 58. 65%) and hyperglycemia( 21. 8%) were the most prevalent risk factors. The common symptoms were hemiplegia( 50. 38%),dysarthria( 25. 56%) and dizziness( 10. 53%). The most common infarction site of patients aged 80 and over with PCI was in pons and cerebellum. The mortality rate was 4. 51% and major disability rate was 24. 06% at 1 month after onset. Conclusions The main risk factor of elderly patients with PCI is atherosclerosis. The clinical manifestations in patients with PCI are complicate and lack of the characteristic presentation for diagnosis. High NIHSS scores and distal territory involved means poor prognosis.

关 键 词：高龄 后循环 脑梗死 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]