缺血性卒中及短暂性脑缺血发作患者颅内外大动脉病变分布情况分析  

Distribution of intra-/extracranial large-artery disturbance of patients with ischemic stroke or transient ischemic attack

作　　者：房砚文[1] 龚涛[1] 

机构地区：[1]卫生部北京医院神经内科,100730

出　　处：《中华全科医师杂志》2013年第10期808-811,共4页Chinese Journal of General Practitioners

基　　金：中央保健专项资金科研课题（B2009A025）;首都医学发展科研基金（2002-2022）

摘　　要：目的 探讨缺血性卒中（ischemic stroke,IS）及短暂性脑缺血发作（transient ischemic attack,TIA）颅内外大动脉病变的分布特点.方法 记录169例IS及TIA患者的病史资料,实验室检查结果,心电图、超声心动图、腹部B超、胸片等检查.同时行颈部及颅内脑血管检查,了解颅内外大动脉病变的程度及分布情况,并分析其病变模式.结果 颅内外大动脉狭窄患者112例（66.3％）,小动脉狭窄57例（33.7％）.颅内外大动脉狭窄的分布以多血管病变模式多见,占63.4％（71/112）.颅内大动脉狭窄的发生率为53.8％（91/169）,明显高于颅外大动脉狭窄发生率35.5％ （60/169）（P＜0.05）.大脑中动脉为最常受累的大动脉,且73.5％为责任血管（36/49）.结论 IS及TIA患者颅内外大动脉狭窄病变发生率高,且以多血管病变模式多见,颅内大动脉狭窄的发生率高于颅外大动脉,大脑中动脉病变为最常受累的大动脉.Objective To explore the distribution characteristics of intra/extracranial large-artery disturbance in patients with ischemic stroke （IS）/transient ischemic attack （TIA）. Methods The medical history information of 169 IS/TIA patients was recorded. The results of laboratory examination, electrocardiogram, echocardiography, abdominal ultrasound and chest radiography were analyzed. At the same time, the intra/extra-eranial large arteries were examined to analyze the degree, distribution and pattern of their disturbance. Results Among them, there were intra/extra-cranial large-arterial stenosis （n = 112, 66. 3% ） and small-arterial disturbance （n = 57, 33.7% ）. Multiple vascular disturbance pattern was more common in patients with intra/extra-cranial large-arterial stenosis （n = 71, 63.4%）. The incidence of intracranial large-arterial stenosis was significantly higher than that of extracranial large-arterial stenosis （53.8% vs. 35.5%, P 〈 0. 05）. And middle cerebral artery was the most commonly affected artery, 36 of those were culprit vessels accounting for 73.5% （ 36/49 ）. Conclusions The IS/TIA patients have a high incidence of intra/extra-eranial large-arterial stenosis. Multiple vascular disturbance is a more common pattern. The incidence of intracranial large-arterial stenosis is greater than that of extracranial and middle cerebral artery is the most common affected artery.

关 键 词：脑血管意外 动脉狭窄 颅内动脉硬化 

分 类 号：R743.3[医药卫生—神经病学与精神病学]