老年腔隙性脑梗死患者的梗死部位及病因分析  

Infarction location and etiology in elderly patients with LI

作　　者：李莹[1,2] 晏丽苹[1] 陈飞[1] 张微微[1] 

机构地区：[1]北京军区总医院神经内科,100700 [2]第三军医大学

出　　处：《中华老年心脑血管病杂志》2012年第11期1127-1129,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的了解老年缺血性脑血管病患者中腔隙性脑梗死的疾病特点。方法回顾性收集我科住院的年龄≥65岁腔隙性脑梗死患者146例,并对其危险因素和梗死部位进行分析。结果腔隙性脑梗死的主要危险因素为高血压(76.0%)和糖尿病(29.5%),颅内动脉粥样硬化或狭窄(56.2%)和颅外颈动脉粥样硬化斑块(58.9%)在腔隙性脑梗死中也较多见。腔隙性脑梗死以基底节为主。颅内动脉粥样硬化与后循环腔隙性脑梗死相关性高(HR=2.552,95%CI:0.05～1.35),颈动脉粥样硬化与前循环腔隙性脑梗死相关性高(HR=2.645,95%CI:0.76～17.9);心源性疾病可能是后循环腔隙性脑梗死的原因之一(HR=1.401,95%CI:0.08～1.83)。结论老年腔隙性脑梗死进行二级预防,大动脉粥样硬化仍是干预重点。Objective To investigate the clinical characteristics of lacunar cerebral stroke in elderly patients with ischemic cerebrovascular disease. Methods Risk factors and infarction location of 146 lacunar cerebral stroke patients at the age ≥65 years were retrospectively analyzed. Results The major risk factors for lacunar cerebral stroke were hypertension, diabetes mellitus,intraerani- al atherosclerosis or stenosis, and extracranial carotid atheroselerotic plaque and stenosis, account- ing for 76.0 %, 29.5 %,56.2% and 58.9%, respectively. Lacunar cerebral stroke was mainly loca- ted in basal ganglia. Intraeranial atherosclerosis was closely related with extracranial lacunar cere- bral stroke（HR： 2. 552,95 %C1：0.： 05-- 1.35） and carotid atherosclerosis was closely related with intracranial lacunar cerebral stroke（ HR-- 2. 645,95%CI：0.76--17.9）. Cardiogenie disease might be one of the risk factors for extracranial lacunar cerebral stroke （HR ： 1. 401,95%CI：0. 08 -- 1.83）. Conclusion Lacunar cerebral stroke should be prevented in elderly patients with stress laid on the intervention of conducting atherosclerosis.

关 键 词：脑梗死 脑缺血 高血压 糖尿病 小动脉硬化 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]