不同卒中分型脑梗死患者脑微出血患病率及严重程度的研究  

An investigation on prevalence and severity of cerebral microbleeds in patients with different stroke classifications of cerebral infarction

作　　者：王凯 荣良群 魏秀娥 陶中海 肖利杰 Wang Kai;Rong Liangqun;Wei Xiue;Tao Zhonghai;Xiao Lijie(Department of Neurology,the Second Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221006,China)

机构地区：[1]徐州医科大学第二附属医院神经内科,221006

出　　处：《中国基层医药》2019年第18期2177-2181,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：江苏省徐州市科技计划项目(KC16SL121).

摘　　要：探讨不同卒中分型脑梗死患者的脑微出血( CMBs)患病率及严重程度.方法采用前瞻性研究,连续选取2016年10月至2017年12月在徐州医科大学第二附属医院神经内科住院治疗的急性脑梗死患者为研究对象,收集临床资料,采用磁敏感加权成像(SWI)技术筛查有无CMBs,按照急性卒中治疗Org 10172试验(TOAST)和英国牛津郡社区脑卒中规划(OCSP)进行卒中分型,明确不同卒中分型脑梗死患者的CMBs患病率及严重程度.结果最终纳入254 例脑梗死患者,其中CMBs组136例(53.54%),无CMBs组118例(46.46%).不同TOAST分型脑梗死患者的CMBs患病率分别为大动脉粥样硬化型(54.29%)、小动脉闭塞型(64.15%)、心源性栓塞型(40.43%)、其他病因型(33.33%)、不明病因型(38.46%),差异有统计学意义(χ^2 =12.206,P=0.016).不同OCSP分型脑梗死患者的CMBs 患病率分别为完全前循环梗死型(43.75%)、部分前循环梗死型(51.19%)、后循环梗死型(49.18%)、腔隙性梗死型(67.53%),差异有统计学意义(χ2 =8.944,P=0.030).不同TOAST分型脑梗死患者的CMBs严重程度分别为大动脉粥样硬化型[轻度(55.26%)、中度(26.32%)、重度(15.79%)]、小动脉闭塞型[轻度(25.00%)、中度(33.82%)、重度(41.18%)]、心源性栓塞型[轻度(57.89%)、中度(26.32%)、重度(15.79%)]、其他病因型[轻度(50.00%)、中度( 33.33%)、重度( 16.67%)]、不明病因型[轻度( 60.00%)、中度( 20.00%)、重度(20.00%)],差异有统计学意义(Fisher精确检验,P=0.025).不同OCSP分型脑梗死患者的CMBs严重程度分别为完全前循环梗死型[轻度(57.14%)、中度(28.57%)、重度(14.29%)]、部分前循环梗死型[轻度(52.50%)、中度(32.50%)、重度( 15.00%)]、后循环梗死型[轻度(50.00%)、中度( 33.33%)、重度(16.67%)]、腔隙性梗死型[轻度(25.00%)、中度(32.69%)、重度(42.31%)],差异有统计学意义(Fisher精确检验,P=0.023).结论不同卒中分型脑梗死患者的CMBs患病率及严重程度不同,其中小动�Objective To investigate the prevalence and severity of cerebral microbleeds (CMBs) in patients with different stroke classifications of cerebral infarction.Methods From October 2016 to December 2017,the clinical data of patients with acute cerebral infarction in the Second Affiliated Hospital of Xuzhou Medical University were collected through the prospective study.The SWI technique was used to screen the CMBs.According to the TOAST and OCSP classifications, the prevalence and severity of CMBs in patients with different stroke classifications of cerebral infarction were analyzed.Results A total of 254 patients with cerebral infarction were enrolled ,there were 136 patients(53.54%) in CMBs group and 118 patients(46.46%) in no CMBs group.The prevalence of CMBs in patients with different TOAST classifications was large artery atherosclerosis ( 54.29%), small -artery occlusion (64.15%), cardioembolism (40.43%), stroke of other determined etiology ( 33.33%), stroke of undetermined etiology(38.46%),and the difference was statistically significant (χ^2 =12.206,P=0.016).The prevalence of CMBs in patients with different OCSP classifications was total anterior circulation infarcts ( 43.75%), partial anterior circulation infarcts ( 51.19%), posterior circulation infarcts ( 49.18%), lacunar infarcts ( 67.53%), and the difference was statistically significant(χ^2 =8.944,P=0.030).The severity of CMBs in patients with different TOAST classifications was large artery atherosclerosis [mild(55.26%),moderate(26.32%),severe(15.79%)],small-artery occlusion[mild(25.00%),moderate (33.82%), severe (41.18%)], cardioembolism [ mild (57.89%), moderate (26.32%),severe(15.79%)),stroke of other determined etiology [ mild(50.00%),moderate (33.33%),severe (16.67%)],stroke of undetermined etiology [ mild(60.00%),moderate (20.00%),severe (20.00%)],and the difference was statistically significant (Fisher exact test,P=0.025).The severity of CMBs in patients with different OCSP classifications was total anterior circulation infarcts [mild(57.14%)

关 键 词：卒中 脑梗死 脑出血 患病率 磁共振成像 

分 类 号：R743.3[医药卫生—神经病学与精神病学]