急性血栓性和栓塞性大脑中动脉M1段闭塞的临床研究  

Clinical study on acute cardio embolism and thrombotic MCAO infarction

作　　者：焦晓东 王栋[2] 张新江[2] 

机构地区：[1]江苏扬州市第二人民医院神经内科,扬州225002 [2]江苏扬州市第一人民医院神经内科,扬州225002

出　　处：《中国实用神经疾病杂志》2011年第4期10-12,共3页Chinese Journal of Practical Nervous Diseases

摘　　要：目的研究急性血栓性和心源性栓塞性大脑中动脉闭塞(MCAO)的临床特点的差异。方法选择5年内急诊住院的被磁共振血管成像(MRA)证实为急性大脑中动脉M1段急性闭塞的患者67例,其中血栓组45例,栓塞组22例,在未接受溶栓治疗的情况下,比较分析两种病因导致的MCAO患者危险因素,入院时及发病后14 d NIHSS评分,出血性转化发生率。结果血栓性MCAO患者年龄小于栓塞性MCAO患者;入院当日血栓形成患者NIHSS评分(6.42±3.38)显著小于栓塞性患者(11.67±8.50),P<0.01,14 d时这种差别仍然存在;栓塞组出血性转化率显著高于血栓形成组。结论栓塞性MCAO患者发病年龄大,临床症状重,预后不良,强烈建议开展超早期的动脉溶栓。Objective To compare the difference of clinical features in acute cardio-embolism and thrombotic MCAO infarction.Methods Sixty-seven acute ischemic stroke patients who had middle cerebral artery M1 segment occlusion determined by MRA,all patients were classified into large artery atherosclerosis thrombotic（LAA） group and cardioembolism group（CE） according to TOAST criteria,45 cases in LAA group,22 cases in CE group.The risk factors,NIHSS score of day admission and day 14,the incidence of hemorrhagic transformation were compared between two groups.Results The age in thrombotic group was lower than in cardioembolism group.NIHSS score of day admission in thrombotic group（6.42±3.38）was less than in cardioembolism group（11.67±8.50）,P0.01,as same as the NIHSS score of day 14 between two groups.The incidence of hemorrhagic transformation in cardioembolism group was higher than in thrombotic group.Conclusion Cardioembolism MCAO patients often occur in older people,with severe clinical symptoms and poor prognosis.It may be strongly recommend carrying out super-early arterial thrombolysis.

关 键 词：脑梗死 栓塞性 动脉粥样硬化 大脑中动脉闭塞 

分 类 号：R743.33[医药卫生—神经病学与精神病学]