缺血性卒中患者脑微出血的相关因素分析  

Factors associated with cerebral microbleeds in patients with ischemic stroke

作　　者：杨松[1] 周志明[1] 张志强[1] 魏宁[1] 翟登月[1] 洪震[1] 高海宁[1] 刘新峰[1] 徐格林[1] 

机构地区：[1]南京大学医学院临床学院(南京军区南京总医院)神经内科,南京210006

出　　处：《中华神经医学杂志》2010年第1期64-67,共4页Chinese Journal of Neuromedicine

摘　　要：目的探讨缺血性卒中患者发生脑微出血（CMBs）的相关因素。方法对85例急性缺血性卒中患者进行磁共振检查，其中包括梯度回波T2加权成像（GE—T2＊WI），并对患者的临床资料和影像学特点进行分析。结果26例（30．6％）患者中共检出CMBs124个，每位患者的CMBs数目在1～16个之间。CMBs在基底节丘脑区和皮质-皮质下区分布较多，在幕下区较少见。发生在脑干的CMBs可有相关症状及体征。CMBs数目与年龄、腔隙性梗死数目及白质疏松程度评分有相关性（r=0．243，P=0．025；r=0．337，P=0．002；r=0．438，P=0．000）。CMBs在GE—T2＊WI上显影良好．部分CMBs可在自旋回波（SE）T2WI及DWI序列上显影。结论CMBs是脑微小血管病变标志．主要预测因素有高龄、多发腔隙性梗塞和白质疏松。Objective To investigate the clinical and neuroimaging features of cerebral microbleeds （CMBs） in patients with ischemic stroke. Methods MRI, including gradient-echo T2＊-weighted MRI, was performed in 85 patients with acute ischemic stroke. Their clinical information and imaging characteristics were analyzed. Results One hundred and twenty-four CMBs were noted in 26 patients （30.6%） with the number of CMBs ranged from 1 to 16 per patient. CMBs were more frequently presented in the cortical-subcortical region and thalamus-basal ganglia than in the cerebellum and brain stem regions. Some CMBs in the brain stem had related neurological symptoms and signs. CMBs, the age of the patient, the number of lacunar infarcts and the white matter changes were correlative （r=0.243,P=-0.025; r=0.337, P=0.025; r=0,438, P=0.000）. CMBs could be well demonstrated in the gradient-echo T2＊-weighted MRI and some larger ones could be demonstrated in the apin-echo T2＊-weighted MRI and DWI. Conclusion CMBs are the sighs for microangiopathy in the brain with advanced age, mutiple lacunar infartion and leukoaraiosis as its main prognosis factors.

关 键 词：脑微出血 缺血性卒中 梯度回波T2加权成像 微血管病 

分 类 号：R743.3[医药卫生—神经病学与精神病学]