不同责任动脉急性小脑梗死患者的临床特征分析  

Clinical Features in Acute Cerebellar Infarction Patients with Different Offending Artery

作　　者：卢迪 毕国荣[1] LU Di;BI Guo-rong(Department of Neurology,Shengjing Hospital Affiliated to China Medical University,Shenyang 110072,China)

机构地区：[1]中国医科大学附属盛京医院神经内科,辽宁省沈阳市110072

出　　处：《实用心脑肺血管病杂志》2018年第9期71-75,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的分析不同责任动脉急性小脑梗死患者的临床特征。方法选取2014年10月—2017年9月中国医科大学附属盛京医院收治的急性小脑梗死患者299例,根据Amarenco's解剖图解分为小脑后下动脉(PICA)梗死组179例,小脑前下动脉(AICA)梗死组41例,小脑上动脉(SCA)梗死组28例,多条小脑动脉(MCA)梗死组51例。比较4组患者TOAST分型、临床表现、脑干累及情况、死亡情况。结果 4组患者TOAST分型比较,差异有统计学意义(P<0.05)。4组患者眩晕、构音障碍发生率比较,差异无统计学意义(P>0.05);PICA梗死组患者共济失调发生率低于SCA梗死组、MCA梗死组(P<0.05),MCA梗死组患者听力障碍发生率高于PICA梗死组、SCA梗死组(P<0.05)。MCA梗死组患者中累及脑干者所占比例高于PICA梗死组(P<0.05);SCA梗死组患者累及脑干者所占比例低于PICA梗死组、AICA梗死组、MCA梗死组(P<0.05)。4组患者病死率比较,差异无统计学意义(P>0.05)。结论急性小脑梗死患者TOAST分型以大动脉粥样硬化(LAA)梗死多见,常见临床表现包括眩晕、共济失调、构音障碍、听力障碍等;不同责任动脉急性小脑梗死患者TOAST分型、临床表现、脑干累及情况均存在一定差异,应注意完善磁共振成像(MRI)检查以明确责任动脉。Objective To analyze the clinical features in acute cerebellar infarction patients with different offending artery.Methods A total of 299 patients with acute cerebellar infarction were selected in Shengjing Hospital Affiliated to China Medical University from October 2014 to September 2017,and they were divided into PICA group(with PICA infarction,n=179),AICA group(with AICA infarction,n=41),SCA group(with SCA infarction,n=28),MCA group(with multiple cerebellar arteries infarction,n=51)according to the offending artery.TOAST types,clinical manifestations,proportion of patients with brain stem lesion and death status were compared in the four groups.Results There was statistically significant difference of TOAST types in the four group(P<0.05).No statistically significant differences of incidence of vertigo or dysarthria was found in the four groups(P>0.05);incidence of ataxia in PICA group was statistically significantly lower than that in SCA group and MCA group,respectively(P<0.05),while incidence of hearing disorder in MCA group was statistically significantly higher than that in PICA and SCA group,respectively(P<0.05).Proportion of patients with brain stem lesion in MCA group was statistically significantly higher than that in PICA group(P<0.05),while proportion of patients with brain stem lesion in SCA group was statistically significantly lower than that in PICA group,AICA group and MCA group,respectively(P<0.05).No statistically significant differences of fatality rate was found in the four groups(P>0.05).Conclusion Large artery atherosclerosis in the major TOAST type in patients with acute cerebellar infarction,which mainly performed as vertigo,ataxia,dysarthria,hearing disorder and so on;there is some difference in TOAST types,clinical manifestations,involvement status of brain stem lesion in cute cerebellar infarction patients with different offending artery,which should take MRI examination in time to identify the offending artery.

关 键 词：脑梗死 小脑疾病 疾病特征 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R742.82[医药卫生—临床医学]