急性脑分水岭梗死进展发生的相关因素分析  

Related factors of progression of cerebral watershed infarction

作　　者：徐辉[1] 方岩[1] 王经忠[1] 杨青松[1] 姬卫东[1] 刘琴[1] 张莹[1] 

机构地区：[1]河南省商丘市第一人民医院神经内科,476000

出　　处：《中华神经医学杂志》2015年第12期1235-1239,共5页Chinese Journal of Neuromedicine

摘　　要：目的探讨影响急性脑分水岭梗死（CW-1）进展发生的临床相关因素。方法选择商丘市第一人民医院神经内科自2011年1月至2015年1月收治的资料完整的CWI患者93例．根据病情进展情况将其分为进展组（29例）和稳定组（64例），比较2组患者一般临床资料、颈部血管易损斑块和颅内外血管狭窄情况。结果进展组与稳定组患者年龄、性别、高血压、脑卒中史、血脂、冠心病、高纤维蛋白原血症、吸烟、饮酒、人院时体温、人院时血白细胞计数和NIHSS评分等方面差异均无统计学意义（P〈0．05）。进展组患者糖尿病、入院后血压降低和颈部血管易损斑块比例明显高于稳定组（48-3％vs 26．6％、72．4％vs 48．4％、44．8％vs 21．9％），差异有统计学意义（P〈0．05）；进展组患者皮质下型脑分水岭梗死比例明显高于稳定组患者（27．6％vs 9．4％1，差异有统计学意义（P〈0．05）。进展组患者大脑中动脉狭窄和颅内外多支动脉狭窄的比例明显高于稳定组患者（24．1％vs 57．8％、27．6％vs 9．4％），差异有统计学意义（P〈0．05）。结论糖尿病、入院后血压下降、颈部血管易损斑块、大脑中动脉狭窄或颅内外多发狭窄、影像学显示为皮质下梗死等特点可能是脑分水岭梗死进展发生的预测指标，应引起重视。Objective To explore the risk factors of progression of cerebral watershed infarction （CWI）. Methods Ninety-three CWI patients, admitted to our hospital from January 2011 to January 2015, were divided into progressive CWI group （n=29） and non-progressive CWI group （n=64） according to the progression of CWI; general conditions, risk factors, vulnerable plaque in carotid arteries and stenosis of intracranial and extracranial arteries were compared between the two groups. Results No significant differences were found in age, gender, history of hypertension, coronary heart disease, stroke, hyperlipemia, hyperfibrinogenemia, smoking, alcohol drinking, NIHSS scores, temperature on admission and leukocytes counting between the two groups （P〉0.05）. The percentages of patients with diabetes, decreasing of blood pressure and vulnerable plaque in carotid arteries in progressive CWI group were significantly higher than those in non-progressive CWI group （48.3% vs. 26.6%, 72.4~/0 vs. 48.4%, 44.8% vs. 21.9%, P〈0.05）; percentage of patients with internal watershed infarction in progressive CWI group was significantly higher than that in non-progressive CWI group （27.6% vs. 9.4%, P〈0.05）; meanwhile, percentages of patients with middle cerebral artery stenosis, multi intracranial and extracranial arteries stenosis in progressive CWI group were significantly higher than those in the non-progressive CWI group （24.1% vs. 7.8%, 27.6% vs. 9.4%, P〈0.05）. Conclusion Diabetes, decreasing of blood pressure, vulnerable plaque in carotid arteries, intemal watershed infarction, middle cerebral artery stenosis, and multi intracranial and extracranial arteries stenosis are the related factors for progressive CWI.

关 键 词：脑梗死 脑分水岭 进展性脑卒中 狭窄 

分 类 号：R743.3[医药卫生—神经病学与精神病学]