无脑动脉狭窄急性脑梗死患者的临床特点  

Clinical characteristics of acute cerebral infarction patients without cerebral arterialstenosis

作　　者：陈卓友[1] 恽文伟[1] 赵进委[1] 向红兵[1] 张志翔[1] 钱传忠[1] 丁新生[2] 

机构地区：[1]南京医科大学附属常州第二人民医院神经内科,213003 [2]南京医科大学第一附属医院神经内科

出　　处：《临床神经病学杂志》2011年第3期218-220,共3页Journal of Clinical Neurology

摘　　要：目的探讨无脑动脉狭窄急性脑梗死（ACI）患者的临床特点。方法对352例ACI患者进行数字减影全脑血管造影（DSA）,根据检查结果分为无动脉狭窄组和动脉狭窄组,比较两组患者临床神经功能缺损评分、卒中危险因素和预后;并比较无动脉狭窄组中前循环梗死亚组与后循环梗死亚组的病情和预后。结果根据DSA结果,无动脉狭窄组70例,动脉狭窄组282例。无动脉狭窄组患者合并高血压、糖尿病以及既往脑卒中、冠心病史者的比率明显低于动脉狭窄组（P〈0.05~0.01）;入院时及发病3个月时美国国立卫生研究院卒中量表（NIHSS）评分均明显低于动脉狭窄组,改良Rankin量表（mRS）评分及3个月卒中复发或死亡率明显低于动脉狭窄组（P〈0.05~0.01）;无动脉狭窄组中后循环梗死亚组患者入院时及发病3个月时NIHSS、mRS评分及死亡率明显高于前循环梗死亚组（P〈0.05~0.01）。结论无明显脑动脉狭窄ACI患者的病情较轻,预后较好;但其中后循环梗死患者预后较差。Objective To explore the clinical characteristics of acute cerebral infarction （ACI） patients without cerebral arterialstenosis. Methods The examination of digital subraction angiography （DSA） was applied in 352 ACI patients, and according to the results they were divided into no-arteriostenosis group and arteriostenosis group. Then, the scores of neurological dysfunction, stroke risk factors and prognosis between the two groups were compared. Moreover, the condition and prognosis between the patients with anterior circulation infarction and posterior circulation infarction in no-arteriostenosis group were compared. Results There were 70 cases belonged to non-arteriostenosis group and 282 cases belonged to arteriostenosis group according to the results of DSA. The percentage of patients combined with hypertension, diabetes and history of stroke or coronary heart disease in non- arteriostenosis group were significantly lower than those in arteriostenosis group （ P 〈 0. 05 - 0.01 ） ; the scores of National Institutes of Health Stroke Scale （NIHSS） at admission and 3 months after onset were significantly lower than those in arteriostenosis group; the score of modified Rankin scale （mRS） at 3 months after onset, recurernce rate or mortality and mortality were significantly lower than those in arteriostenosis group（ P 〈 0.05 -0. 01 ）. In the non-arteriostenosis group, the scores of NIHSS at admission and 3 months after onset, mRS and mortality in posterior infarction subgroup were significantly higher than those in anterior infarction subgroup （P〈0.05- 0. 01 ）. Conclusions The condition of ACI patients without arteriostenosis are not severe and the prognosis is better. But the prognosis will be worse in the patients with posterior circulation infarction.

关 键 词：脑梗死 脑动脉狭窄 临床特点 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]