后循环脑梗死的临床特点及相关危险因素分析  

Clinical manifestations and risk factors in posterior circulation ischemic stroke

作　　者：陈玉辉[1] 王音[1] 徐蕾[1] 李伟[1] 罗瑞[1] 龚涛[1] 卢桂静[2] 

机构地区：[1]卫生部北京医院神经内科,100730 [2]中南大学湘雅医院心血管内科

出　　处：《中国心血管杂志》2014年第2期101-104,共4页Chinese Journal of Cardiovascular Medicine

摘　　要：目的分析后循环脑梗死的临床表现、病变部位和危险因素，为预测后循环脑梗死的预后．并进一步为预防后循环脑梗死的发生和发展提供科学依据。方法前瞻性研究收集自2011年1月至2012年12月共110例后循环脑梗死患者的临床资料，分析症状和体征的出现频率，记录病变部位和危险因素．推测后循环脑梗死的病因。结果后循环脑梗死患者的年龄39～92岁，平均（68．1±11．9）岁，男性患者占66．4％。后循环脑梗死最常见的症状为头晕／眩晕（69．1％），肢体无力（47．3％），一般常见的症状为言语不清（29．1％），行走不稳（26．4％）和吞咽困难／饮水呛咳（24．5％）。最常见的体征为肢体瘫痪（55．5％），Babinski征／Chaddoek征阳性（47．3％），共济失调（42．7％），中枢性面瘫（40．0％）和感觉减退（30．0％）。后循环脑梗死的危险因素有高血压（76．4％），糖尿病（44．5％），吸烟（42．7％），血脂异常（34．5％）和冠心病（26．4％）。病变部位以脑干病变最多（40．9％），其次为后循环供血区多发性脑梗死（31．8％）。大动脉硬化是后循环脑梗死主要的病因，颅内动脉狭窄（33．6％）和颅外动脉狭窄（34．5％）较常见。结论后循环脑梗死最常见的症状和体征是头晕／眩晕．肢体瘫痪，危险因素是高血压、糖尿病、吸烟、血脂异常和冠心病，脑干梗死最常见，颅内外大动脉病变是主要的病因。Objective To investigate the clinical characteristics and risk factors of posterior circulation ischemic stroke （PCI）. Methods This was a prospective study involved 110 PCI patients from January 2011 to December 2012. The frequencies of various symptoms and signs, the risk factors, lesions location and possible mechanism of PCI were analyzed. Results Patients aged from 39 to 92 with average （68. 1 ± 11.9） years old, and males accounted for 66.4%. The most common symptoms in PCI were dizziness/vertigo （69. 1% ）, limbs weakness （47.3%） , and then were dysarthria （29. 1% ） , unsteadiness （26.4%） and dysphagia （24. 5% ）. The most common signs were limbs paralysis （55.5%）, Babinski sign/Chaddock sign （ 47. 3% ） , ataxia （ 42. 7% ） , central facial palsy （ 40. 0% ） and hypesthesia （30. 0% ）. The risk factors for PCI were hypertension （76.4%） , diabetes mel｜itus （44. 5% ）, smoking （42. 7% ）, hyperlipidemia （34. 5% ） and coronary heart disease （26. 4% ）. Lesions at brainstem were most common （40. 9% ） and then were multiple lesions （31.8%）. Intracranial and extracranial artery stenosis was comparable （ 33.6% vs. 34. 5% ）, large artery disease was the main mechanism for PCI. Conclusions The most common symptoms and signs of PCI often are dizziness/vertigo and limbs paralysis.Hypertension, diabetes mellitus, smoking, hyperlipidemia and coronary heart disease are risk factors of PCI. Brainstem lesions are most common and large artery disease is the main mechanism of PCI.

关 键 词：后循环脑梗死 体征和症状 危险因素 病灶 

分 类 号：R743.3[医药卫生—神经病学与精神病学]