68例急性小脑梗死患者的颅脑磁共振特点与病因及预后的关系  

Correlation analysis between brain magnetic resonance characteristics and the etiology and prognosis in 68 cases with acute cerebellar infarction

作　　者：郝悦含[1] 何志义[1] 

机构地区：[1]中国医科大学附属第一医院神经内科,沈阳110001

出　　处：《卒中与神经疾病》2015年第4期230-233,共4页Stroke and Nervous Diseases

摘　　要：目的探讨急性小脑梗死患者颅脑磁共振特点与病因及预后的关系。方法收集临床及影像学检查确诊的68例急性小脑梗死患者,总结其颅脑磁共振特点,分析不同供血动脉受累的相关病因及预后。结果 PICA组比例最高为44.1%,SCA组占16.2%,AICA组占10.3%,多动脉受累组占11.8%,同时伴幕上受累组占17.6%。大动脉粥样硬化是PICA梗死的主要原因(P<0.05),心源性栓塞是伴幕上受累的小脑梗死的主要原因(P<0.05),其余动脉供血区梗死未见明显相关病因(P>0.05)。出院时及3个月后随访时mRS≥3或死亡患者例数多动脉受累组明显多于单动脉受累组,且差异明显(P<0.05)。结论 TOAST分型中的大动脉粥样硬化型和心源性栓塞与受累动脉供血区有一定关系,多动脉受累比单动脉受累预后差。Objective To explore the relation between different areas affected artery and etiology and prognosis of stroke by the observation of brain MRI features of acute cerebellar infarction. Methods Characteristics of brain MRI were summarized and etiology and prognosis of different artery involvement were analyzed in 68 patients with acute cerebellar infarction confirmed by clinical and radiographic examination. Results PICA group accounted for the highest percentage of 44. 1 %. SCA group accounted for 16. 2%. AICA group accounted for 10. 3%. Multiple arteries involvement group accounted for ll. 8%, and simultaneous impairment of supratentorial territories with the group accounted for 17. 6%. Large-artery atherosclerosis was the main etiology of PICA infarction （P〈0. 05）, and Cardioembolism was the leading cause of involvement on the supratentorial infarction （P〈0. 05） with the remaining artery territory infarction cause no significant correlation （P〉0. 05）. Number of patients with mRS,3 or died in multiple arteries involvement group were significantly more than the single artery involvement group at discharge and 3 months follow-up , and the difference was statistically significant （P〈0. 05）. Conclusions There is relevance between TOAST classification of large-artery atherosclerosis and cardio embolism and affected artery territory. Multiple arteries involvement group has worse prognosis than the single artery involvement group.

关 键 词：小脑梗死 小脑后下动脉 小脑上动脉 小脑前下动脉 病因 预后 

分 类 号：R743[医药卫生—神经病学与精神病学] R445[医药卫生—临床医学]