老年人大动脉粥样硬化与小动脉病变所致皮质下小梗死的临床研究  

Clinical Features of Acute Small Subcortical Infarcts due to Large Artery Atherosclerosis in Aged People

作　　者：刘嘉晖[1] 赵宇[2] 欧阳嶷[1] 戚其学[1] 

机构地区：[1]中国医科大学附属第一医院神经内科,辽宁沈阳110001 [2]中国医科大学附属盛京医院急诊科,辽宁沈阳110004

出　　处：《中国血液流变学杂志》2013年第2期232-234,242,共4页Chinese Journal of Hemorheology

摘　　要：目的探讨老年人大动脉粥样硬化与小动脉病变所致皮质下小梗死（smallsubcorticalinfarction，SSI）的临床与影像学表现。方法收治的57例老年人急性SSI患者根据TOAST标准被分为大动脉粥样硬化性卒中（1argearteryatherosclerosis，LAA）（n=26）和小动脉闭塞性卒中（smallarteryocclusion，SAO）（n=31）。比较其临床经过及MRI、弥散加权成像（diffusion—weightimaging，DWI）、磁共振血管造影（magneticresonanceangiography，MRA）。采用Barthel指数（BarthelIndex，BI）评价缺血性卒中患者发病21d和90d时的转归。结果LAA所致SSI患者头MRI、DWI显示为多发小梗死灶（P〈0．01），而且以侧脑室旁为主（P〈0．01）。SAO组SSI患者预后较好。结论大动脉粥样硬化不仅可导致该动脉供血区大面积梗死，也可能导致SSI，多为多发性梗死，且预后不良。故应gCSSI患者积极行MRA检查，针对病因采取积饭治疗措施，以防}H现大面积梗死。Objective To investigate the difference of clinical features between two kinds of acute small subcortical caused by infarcts large artery atherosclerosis and small vessel disease.Methods The hospitalized patients with acute SSI were divided into large atherosclerotic stroke group（n=26） and small-artery occlusive stroke group（n=31） according to TOAST criteria.The neuroimaging features between the two groups were compared.The outcome of patients was evaluated with Barthel Index（BI） at day 21 and 90 after stroke.Results Patients in the LAA group had multiple lesions（P 〈 0.01） in MRI and DWI.The infarcts were focused on the region adjacent to lateral ventricle（P 〈 0.05）.Conclusion Large artery atherosclerosis can lead to large area cerebral infarction,but also SSI.MRA is important to patients with SSI in order to prevent the large area cerebral infarction in the future.

关 键 词：皮质下小脑梗死 动脉粥样硬化 磁共振 

分 类 号：R743[医药卫生—神经病学与精神病学]