58例非瓣膜病心房颤动致脑梗死的临床、CT/MRI分析  

Clinical and CT/MRI analysis of 58 cases in cerebral infarction patients caused by nonvalvular atrial fibrillation

作　　者：霍本良[1] 潘庆丽[1] 李月娟[2] 赵建华[2] 蒋杞英[3] 

机构地区：[1]开封市第二人民医院心内科,河南开封475002 [2]河南省人民医院神经内科,河南郑州450003 [3]河南大学医学院细胞与分子免疫学重点实验室,河南开封475004

出　　处：《临床荟萃》2015年第10期1144-1147,共4页Clinical Focus

基　　金：国家自然基金资助项目(81270142);河南省卫生厅科技计划项目(20083106);河南省科技厅科技计划项目(132300410425)

摘　　要：目的探讨非瓣膜病心房颤动致脑梗死的病因、临床及影像特点。方法对58例非瓣膜病心房颤动致脑梗死患者的既往史、临床表现、心电图、心动超声图、CT、MRI、CHA2DS2-VASc评分进行回顾性分析。结果活动状态起病36例,安静状态起病22例,大面积脑梗死52例;死亡8例,好转50例;出现出血转化46例,其中病情加重28例,缺血再灌注18例;多发小梗死未见出血转化4例;CHA2DS2-VASc≥3分55例,CHA2DS2-VASc 0~2分3例。结论非瓣膜病心房颤动致脑梗死多在活动状态起病,多为大面积脑梗死,易出现出血转化。Objective To analyze the etiology,clinical characteristics and imaging features of cerebral infarctionwhich were caused by nonvalvular atrial fibrillation.Methods The anamnesis,clinical manifestation,eletrocardiogram（ECG）,echocardiography,computetized tomography（CT）,magnetic resonance imaging（MRI）and CHA2DS2-VASc score of 58 patients with cerebral infarction which were caused by nonvalvular atrial fibrillation were analyzed retrospectively.Results Among 58 cases,36cases had an active onset,others had a quiet onset;large area cerebral infarction was found in 52cases;8cases died,improvement in 50cases;46cases presented hemorrhagic transformation,deterioration in 28cases;While 18 cases showed ischemia reperfusion injury,and 4cases of multiple small cerebral infarcts did not present hemorrhagic transformation;55cases CHA2DS2-VASc score≥3,others were0to2 points.Conclusion The cerebral infarction induced by nonvalvular atrial fibrillation is common on the onsets of and the active state,most manifest as the large area cerebral infarction hemorrhagic transformation easily occurs which were.

关 键 词：脑梗死 心房颤动 出血转化 再灌注 CHA2DS2-VASc评分 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R541.75[医药卫生—临床医学]