皮质分水岭脑梗死与内分水岭脑梗死的病因及危险因素分析  

Analysis of etiology and risk factors for cortical and internal watershed infarction

作　　者：朱延霞[1] 安中平[2] 

机构地区：[1]天津医科大学研究生院,天津300070 [2]天津环湖医院神经内科

出　　处：《中国慢性病预防与控制》2013年第2期140-142,共3页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：天津市科技支撑计划重点项目(07ZCGYSF02800)

摘　　要：目的分析皮质分水岭脑梗死(CWSI)与内分水岭脑梗死(IWSI)的病因及危险因素,为分水岭脑梗死(WSI)的预防提供依据。方法选取2011年2月至2012年8月我院卒中单元收治的WSI患者141例为研究对象,根据颅脑磁共振成像/计算机体层摄影(MRI/CT)分为CWSI组和IWSI组,比较两组患者的基线资料、脑供血动脉狭窄及颈动脉斑块稳定性。结果 141例WSI患者分为IWSI组94例,CWSI组47例,两组基线资料比较,CWSI组低密度脂蛋白水平为(3.41±0.73)mmol/L,IWSI组为(2.96±0.82)mmol/L,两组比较,差异有统计学意义(P<0.05)。IWSI组颈动脉不稳定斑块43例(45.7%),而CWSI组33例(70.2%),两组比较,差异有统计学意义(P<0.05),141例WSI患者中,98例(68.5%)有动脉狭窄,MCA狭窄46例(32.6%),其中CWSI组9例(19.1%),IWSI组37例(39.4%),两组比较,差异有统计学意义(P<0.05)。ICA狭窄41例(29.1%),其中IWSI组23例(24.5%),CWSI18例(38.3%),两组比较,差异无统计学意义(P>0.05)。结论 WSI的形成与颈内动脉、大脑中动脉狭窄或闭塞密切相关,大脑中动脉狭窄是IWSI的重要危险因素,低密度脂蛋白偏高及颈动脉不稳定斑块是CWSI的重要危险因素。Objective To analysis the etiology and risk factors of cortical watershed infarction （CWSI） and internal watershed infarction （IWSI） and to provide the basis for preventing WSI. Methods One hundred forty one cases with WSI served as subjects hospitalized in the stroke unit of our hospital during 2011 February to 2012 August, who were divided into CWSI group （47 cases） and IWSI group （94 cases）, according to the head of MRI/CT. The differences of baseline inform data, cerebral artery stenosis and carotid plaque stability between two groups were compared. Results The compassion of baseline data between two groups indicated that the level of low density lipoprotein in CWSI group was （3.41±0.73）mmol/L, which was significantly higher than that [（2.96±0.82）mmol/L] in IWSI gronp（P〈0.05）. There were 43 cases（45.7%） with carotid unstable plaque in IWSI group and 33 cases（70.2% ） in CWSI group, the difference between two groups was significant （P〈0.05）. There were 98 cases（68.5% ） with carotid stenosis in 141 WSI cases, 46 cases （32.6%） with MCA including 9 cases（19.1%） in CWSI group and 37 cases （39.4%） in IWSI group. The difference between two groups was significant （P〈0.05）. There were 41 cases （29.1% ） with internal carotid stenosis in 141 WSI cases, including 18 cases （38.3%） in CWSI group and 23 cases （24.5%） in IWSI group. The difference between two groups was not significant （P〉0.05）. Conchmion The WSI formation is associated closely with internal carotid artery/middle cerebral artery stenosis/occlusion. The middle cerebral artery stenosis is the important risk factor for IWSI, also the high level of low density lipoprotein and carotid unstable plaque were the important risk factors for CWSI.

关 键 词：皮质分水岭脑梗死 内分水岭脑梗死 病因 危险因素 

分 类 号：R743[医药卫生—神经病学与精神病学]