出血性脑梗死的临床特点及危险因素分析  

Analysis of the clinical features and risk factors of hemorrhagic infarction

作　　者：陆景红[1] 周颖[1] 李宗友[1] 王幼萌[1] 许静[1] 尚志红[1] 

机构地区：[1]阜阳市人民医院神经内科,安徽阜阳236004

出　　处：《华夏医学》2011年第5期514-517,共4页Acta Medicinae Sinica

摘　　要：目的:探讨出血性脑梗死(HI)的发病机制、危险因素及临床特点。方法:回顾分析2496例脑梗死患者中108例HI患者的临床和影像资料;比较HI组和非HI组患者的皮质型梗死、脑梗死面积、神经功能缺损程度、血糖、血压。结果:HI发生率为4.3%,多发生在脑梗死后2周内,影像学上多为非血肿型,血肿型少见,但血肿Ⅱ型预后差。HI与皮质型梗死、大面积脑梗死、神经功能缺损严重程度、高血压及高血糖有关。结论:除血肿Ⅱ型外HI对患者的病情和预后一般无明显不良影响。对具有皮质型梗死、大面积脑梗死、心源性脑栓塞、严重神经功能缺损、高血糖、高血压等危险因素的患者须密切动态观察,警惕梗死后出血的可能,及时复查头颅CT/MRI以调整治疗方案,MRI比CT诊断HI更优越。Objective：To investigate the nosogenesis,risk factors and clinical features of hemorrhagic infarction（HI）. Methods： 108 patients with CT-documented or MRI-documented HI among 2496 cerebral infarction patients were collected and information about their clinical and image document was analyzed retrospectively. The cortical infarction, infarct size, neurologic impairment, blood glucose and blood pressure between HI and non-hemorrhagic infarction（NHI） were compared. Results： Hemorrhagic infarction incidence rate was 4.3~. Hemorrhage often appeared in two week of cerebral infarction, most of them were negative hematoma, and hematoma were few, but paren- chymal hemat0ma type 2 were unfavorable prognosis. HI was related to cortical infarction, large areas of infarction, severe neurologic impairment, high blood pressure and high blood sugar. Con- clusions：Only parenchymal hematoma type 2 independently causes clinical deterioration and impairs prognosis. The patients with cortical infarction, large areas of infarction, severe neurologic impair- ment, high blood pressure, or high blood sugar should be closely observed dynamically, attention to the possibility of hemorrhagic infarction, timely reviewing head CT/MRI and adjusting the treat- ment program. For the diagnosis of HI, MRI was better than CT.

关 键 词：出血性脑梗死 危险因素 临床特点 

分 类 号：R743.3[医药卫生—神经病学与精神病学]