孤立脑桥梗死的临床研究  

Isolated pontine infarction

作　　者：杨磊[1] 秦伟[1] 张小雨[1] 李悦[1] 徐霁华[1] 胡秀朝[1] 顾华[2] 胡文立[1] 

机构地区：[1]首都医科大学附属北京朝阳医院神经内科,100020 [2]首都医科大学附属北京朝阳医院放射科,100020

出　　处：《中华老年心脑血管病杂志》2016年第3期274-277,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：国家自然科学基金(81271309)

摘　　要：目的比较不同类型孤立脑桥梗死的发病机制。方法选择脑桥梗死患者102例,根据基底动脉是否存在狭窄分为载体动脉狭窄组16例和载体动脉正常组86例,载体动脉正常组又根据头颅MRI分为小血管病组29例及穿支动脉粥样硬化组57例。比较不同分组之间临床与影像的不同。结果与载体动脉正常组比较,载体动脉狭窄组近端病变和颅内动脉粥样硬化狭窄比例明显增高(93.8%vs 66.3%,100.0%vs 77.6%,P<0.05)。与小血管病组比较,穿支动脉粥样硬化组糖尿病、颅内动脉粥样硬化狭窄、美国国立卫生研究院卒中量表(NIHSS)评分明显升高,吸烟比例明显降低(P<0.05,P<0.01)。载体动脉狭窄组、小血管病组和穿支动脉粥样硬化组吸烟、颅内动脉粥样硬化狭窄及NIHSS评分比较,差异有统计学意义(P<0.05,P<0.01)。结论孤立脑桥梗死存在不同的病因和发病机制。对于穿支动脉疾病患者要积极寻找系统性动脉粥样硬化的证据。Objective To compare the pathogenesis of different kinds of isolated pontine infarction. Methods One hundred and two pontine infarction patients were divided into parent artery stenosis （PAS） group（n=16）and normal PA group （n=86） according to their basilar artery stenosis. The patients in normal PA group were further divided into small vascular disease （SVD） group （n=29） and perforating branch atheromatous disease （BAD） group （n： 57） according to their cerebral MRI. Their clinical and radiological data were compared. Results The incidence of proximal lesion and intracranial artery atherosclerotic stenosis was significantly higher in PAS group than in normal PA group （93.8% vs 66.3%,100.0% vs 77.6%,P〈0.05）. The incidence of diabetes mellitus,intraeranial artery atherosclerotic stenosis and the NIHSS score were significantly higher whereas the number of smokers was significantly smaller in SVD group than in perforating BAD group. There was significant difference in smoking, artery atherosclerotic stenosis and NIHSS score among PAS group,SVD group and perforating BAD group （P〈0.05,P〈0. 01）. Conclusion The etiology and pathogenesis of isolated pontine infarction are different. Evidence of systemic atherosclerosis should thus be actively searched for perforating BAD patients.

关 键 词：脑梗死 动脉粥样硬化 糖尿病 高血压 吸烟 

分 类 号：R743.3[医药卫生—神经病学与精神病学]