大脑前动脉区域梗死的临床特征及其预后影响因素研究  

Clinical Features of Infarction in the Territory of Anterior Cerebral Artery and Its Influencing Factors for Prognosis

作　　者：陈晓丽[1] 陈为安[1] 鲍剑虹[1] 王汉旻[1] 

机构地区：[1]温州医学院附属第一医院神经内二科,浙江省温州市325000

出　　处：《中国全科医学》2013年第18期2124-2126,共3页Chinese General Practice

基　　金：温州市科技计划项目(Y20100149)

摘　　要：目的探讨大脑前动脉(ACA)区域梗死的临床特征及其预后的影响因素。方法回顾性分析我院2009年4月—2012年4月收治的86例ACA区域梗死患者的临床资料,总结其临床表现、影像学表现、病因及发病机制等,评估患者发病90 d时预后情况。结果本组86例患者中运动障碍80例(93.0%),胼胝体累及62例(72.1%),大动脉粥样硬化63例(73.3%)。预后良好者73例,预后不良者13例。多因素Logistic回归分析显示,辅助运动区病变〔OR=2.738,95%CI(1.213,6.181),P=0.015〕,基线脑卒中患者临床神经功能缺损程度评分(NDS评分)增高〔OR=3.578,95%CI(1.089,11.759),P=0.036〕对回归方程的影响有统计学意义。结论运动障碍是ACA区域梗死的主要临床表现,内源性ACA动脉粥样硬化病变是主要病因,胼胝体最易受累;辅助运动区病变、基线NDS评分增高是患者预后不良的危险因素。Objective To study the clinical manifestations of patients with ischemic stroke in the territory of the anteri-or cerebral artery （ACA） and to analyze influencing factors for prognosis. Methods 86 patients with acute ischemic stroke inACA confirmed by MRI from April 2009 to April 2012were included. We analyzed the demographics, risk factors, clinical features ,laboratory and neuroimaging data of those patients. They were followed up for 90 days. Results 80 cases had motor deficit,accounting for 93. 0%. 62 cases had Corpus callosum, accounting for 72. 1%. 63 cases had atherosclerosis infarction, accountingfor 73. 3%. We divided the patients into good prognosis group （73 patients） and poor prognosis group （13 patients） after ninetydays follow - up according to the NDS score. Multivariate Logistics regression analysis demonstrated that both the baseline NDS andsupplementary motor area （ SMA） involved were independent associated with the poor outcome. Conclusion Motor deficit is themost common symptom of brain infarction in the territory of the ACA. Corpus Callosum is the most frequent site involved. The mainaetiology of ACA infarctions is ACA atherosclerosis. The high scores of baseline NDS and supplementary motor area （ SMA） involved are independent factors for poor prognosis.

关 键 词：梗死 大脑前动脉 临床特征 预后 危险因素 

分 类 号：R743.33[医药卫生—神经病学与精神病学]