高龄后循环脑梗死患者的临床特点分析  

Clinical characteristics of advance-aged posterior circulation ischemic stroke patients

作　　者：刘猛[1] 吴坚[1] 盛世英[1] 练学淦[1] 唐晓春[1] 姜晴晴[1] 陈利民[1] 

机构地区：[1]苏州大学附属第三医院神经内科,常州213003

出　　处：《中华老年心脑血管病杂志》2014年第8期830-832,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨高龄后循环脑梗死患者的发病危险因素、临床表现、影像学特点和预后。方法选择522例老年急性后循环脑梗死患者,依据年龄分为高龄组152例（≥80岁）和老年组370例（60-79岁）。比较2组患者的临床症状、影像学资料和发病危险因素,并在病后30d进行改良Rankin量表评估分析预后。结果与老年组比较,高龄组头晕和双侧肢体乏力、心房颤动比例明显升高（42.11%vs 29.73%、7.89%vs 3.24%、17.11%vs 10.00%,P〈0.05,P〈0.01）。高龄组最常累积后循环血管的中段和远段。与老年组比较,高龄组枕叶单发梗死和多发梗死明显升高;预后不良比例明显升高（28.29%vs 17.57%,P〈0.01）。结论高龄后循环脑梗死患者在发病危险因素、临床表现以及影像学特点均与老年后循环脑梗死患者存在差异,高龄后循环脑梗死患者预后相对较差。Objective To study the risk factors,clinical manifestations,radiological features and outcome of advance-aged posterior circulation ischemic stroke patients.Methods Five hundred and twenty-two posterior circulation ischemic stroke patients with their age≥60years were divided into≥80years old group（n=152）and 60-79 years old group（n=370）.Their risk factors,clinical manifestations,radiological data and outcome were compared according to the modified Rankin Scale（mRS）on day 30 after onset of posterior circulation ischemic stroke.ResultsThe incidence of dizziness,bilateral limb weakness and atrial fibrillation was significantly higher in≥80years old group than in 60-79 years old group（42.11%vs 29.73%,7.89%vs 3.24%,17.11%vs 10.00%,P〈0.05,P〈0.01）.The most commonly involved were the middle and distal segments of posterior circulation vessels in advance-aged posterior circulation ischemic stroke patients.Occipital lobe infarction was more common and the outcome was poorer in≥80years old group than in 60-79 years old group（28.29%vs 17.57%,P〈0.01）.Conclusion The risk factors,clinical manifestations and radiological features of advance-aged posterior circulation ischemic stroke patients are different from those of aged posterior circulation ischemic stroke patients.The outcome is poorer in advance-aged posterior circulation ischemic stroke patients than in aged posterior circulation ischemic stroke patients.

关 键 词：脑梗死 头晕 心房颤动 枕叶 危险因素 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]