双侧小脑急性梗死模式观察与分析  

Analysis of acute bilateral cerebellar infarction patterns

作　　者：张伟晴 蔡俊秀 樊露 王健[1] 辛岳[1] 王玉洁[1] Zhang Weiqing;Cai Junxiu;Fan Lu;Wang Jian;Xin Yue;Wang Yujie(Department of Neurology,Liaoning Provincial People's Hospital,Shenyang 110016,Liaoning Province,China)

机构地区：[1]辽宁省人民医院神经内科,沈阳110016

出　　处：《中华老年心脑血管病杂志》2019年第4期403-406,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨双侧小脑急性梗死模式和可能的病因机制。方法连续收集2016年3月～2018年3月辽宁省人民医院神经内科住院治疗的急性小脑梗死患者140例,根据梗死部位分为单侧小脑梗死(UCI)组98例和双侧小脑梗死(BCI)组42例,对比2组一般临床资料和影像学资料。结果 2组视物旋转、耳聋耳鸣、头痛、小脑后下动脉(PICA)区域性梗死、PICA小梗死、小脑下前动脉(AICA)区域性梗死、AICA小梗死、分水岭梗死、伴延髓梗死及伴右椎动脉狭窄比较,差异无统计学意义(P>0.05)。BCI组脑卒中史、SCA区域性梗死、SCA小梗死(54.76%vs 23.47%)、伴脑桥梗死、伴中脑梗死、伴其他后循环梗死、伴前循环梗死、伴左椎动脉狭窄、伴基底动脉狭窄比率明显高于UCI组,单纯头晕(23.81%vs 59.18%)、走路不稳症状(28.57%vs 48.98%)明显低于UCI组,差异有统计学意义(P<0.05,P<0.01)。多因素logistic回归分析结果显示,SCA区域性梗死(95%CI:0.550～0.685,P=0.011)和SCA小梗死(95%CI:0.098～0.891,P=0.030)与BCI独立相关。结论 BCI患者临床症状较UCI复杂、SCA供血区的区域性梗死和小梗死较多见,多伴有小脑以外的后循环梗死及基底动脉狭窄。Objective To study the pattern and pathogenesis of acute bilateral cerebellar infarction.Methods One hundred and forty acute bilateral cerebellar infarction patients admitted to our hospital from March 2016 to March 2018 were divided into unilateral cerebellar infarction(UCI)group(n=98)and bilateral cerebellar infarction(BCI)group(n=42).Their clinical and imaging data were compared and analyzed.Results No significant difference was found in visual rotation,deafness,tinnitus,headache,posterior inferior cerebellar artery(PICA)territory infarction,PICA small infarction,anterior inferior cerebellar artery(AICA)territory infarcttion,AICA small infarction,watershed infarction,medullary infarction and right vertebral artery stenosis between the two groups(P>0.05).The incidence of cerebral stroke,superior cerebellar artery(SCA)territory infarction,concomitant pons infarction,concomitant midbrain and posterior circulation infarctions,left vertebral artery and basilar artery stenosis was significantly higher while that of simple dizziness and instable gait was significantly lower in BCI group than in UCI group(P<0.05,P<0.01).Multivariate logistic regression analysis showed that SCA territory infarction and SCA small infarction were the independent risk factors for BCI(95%CI:0.550-0.685,P=0.011;95%CI:0.098-0.891,P=0.030).Conclusion The clinical symptoms of BCI patients are more complicated than those of UCI patients.Regional infarction and small infarction are common in SCA blood supply area usually with comcomittant posterior circulation infarction and basilar artery stenosis.

关 键 词：脑梗死 椎底动脉供血不足 磁共振成像 弥散 高血压 糖尿病 冠心病 心房颤动 

分 类 号：R743.3[医药卫生—神经病学与精神病学]