大脑中动脉和颈内动脉严重狭窄或闭塞致脑梗死临床和影像表现差异性的研究  

The Research of Difference of Clinical and Imaging Presentation between Middle Cerebra Artery and Internal Carotid Artery Severe Stenosis Or Obstruction

作　　者：白雪[1] 高晓梅[1] 张亚丽[1] 

机构地区：[1]赤峰市医院神经内科,内蒙古赤峰024000

出　　处：《内蒙古医学杂志》2015年第9期1033-1036,共4页Inner Mongolia Medical Journal

摘　　要：目的探讨大脑中动脉和颈内动脉严重狭窄或闭塞致脑梗死模式的差异性。方法回顾性分析2012年6月至2014年9月因急性脑梗死收住我院的伴有颈内动脉或大脑中动脉≥50%狭窄或闭塞患者的临床和影像资料。依据患者脑动脉狭窄或闭塞部位分为ICA组和MCA组。比较两组间临床分型和影像分型的差异性。结果入组132名符合标准的患者,ICA组73人,MCA组59人。MCA组腔隙性脑梗死、皮质下梗死的发生率高于ICA组,两组间比较差异有统计学意义(分别为52.5%VS 26.0%,P=0.002;50.8%VS19.2%,P<0.001)。ICA组完全前循环梗死的发生率、NIHSS评分和区域性梗死的发生率高于MCA组,两组间比较差异有明显统计学意义(分别为34.2%VS 10.2%,P=0.001;5.6±3.0VS 3.7±1.5,P<0.05;28.8%VS 5.1%,P<0.001)。结论虽然MCA和ICA病变患者引起缺血性卒中的机制相似,但是其临床及影像缺血模式有着明显差异性,加强血管损害和卒中模式相关性的理解有助于缺血性卒中急性期治疗以及二级预防。Objective To explore the difference of infarction model between middle cerebral artery（MCA）and internal carotid artery（ICA）severe stenosis or obstruction.Methods We retrospectively review the clinical and imaging information of acute cerebral infarction patients who admitted in our department due to middle cerebral artery or internal carotid artery≥50%stenosis or obstruction from june 2012 to september 2015.Patients were devided into ICA group and MCA group according to location of lesions.The differences of clinical typing and imaging classification among two groups were compared.Results 132 eligible cases were enrolled.There were 73 patients in ICA group and 59 patients in MCA group.MCA group had a higher incidence of lacunar infarctin and subcortical infarction than ICA group,there were statistical differences between two groups（respectively 52.5% vs 26.0%,P=0.002;50.8% vs 19.2%,P〈0.001）;ICA group had a higher prevalence of total arterior circulatin infarction,NIHSS scores and incidence of territory infarction than MCA group,there were statistical differences between two groups（respectively34.2% vs 10.2%,p=0.002;5.6±3.0VS 3.7±1.5,P〈0.05;28.8% vs 5.1%,P〈0.001）.ConclusionAlthough the mechanisms of ischemic stroke between MCA and ICA lesions are similar,their clinical and imaging ischemic model are significantly differrent.To strengthen the understanding of correlation between artery lesion and stroke model is benificial to the treatment and secondary prevention of ischemic stroke.

关 键 词：脑梗死颈内动脉狭窄 大脑中动脉狭窄 梗死模式 

分 类 号：R743.3[医药卫生—神经病学与精神病学]