急性胼胝体梗死患者的临床特征和预后分析  

Clinical features and prognosis analysis of acute corpus callosum infarction

作　　者：彭定越 王玮婧 张为[1] 杨乙[1] 包卓华 吕渊[1] 李淑娟 PENG Dingyue;WANG Weijing;ZHANG Wei;YANG Yi;BAO Zhuohua;LYU Yuan;LI Shujuan(Department of Neurology,Jiangbin Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021;Department of Neurology,Fuwai Hospital,Chinese Academy of Medical Sciences,Beijing 100034,China)

机构地区：[1]广西壮族自治区江滨医院神经内科,南宁530021 [2]中国医学科学院阜外医院神经内科,北京100034

出　　处：《基础医学与临床》2025年第2期234-238,共5页Basic and Clinical Medicine

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z-A20220236)。

摘　　要：目的探讨急性胼胝体梗死的临床特征,以及影响其预后的相关因素。方法回顾2019年1月至2023年10月广西南宁江滨医院神经内科和2022年1月至2022年12月中国医学科学院阜外医院神经内科住院的1466例急性脑梗死患者,选择经头颅磁共振(MRI)确诊的21例急性胼胝体梗死患者(观察组)和同时期25例孤立的幕上皮层下梗死患者(对照组),比较两组患者的临床资料,总结急性胼胝体梗死的临床特征,以及分析影响胼胝体梗死组预后的相关因素。结果急性胼胝体梗死占同期急性脑梗死患者的1.43%(21/1466),主要危险因素为高血压、高脂血症等,以肢体瘫痪、认知障碍和言语功能下降为主要表现。与对照组相比,胼胝体梗死组的发病-就诊时间更长(P<0.05),认知损害更多见(P<0.05),轻型卒中比例更高(P<0.05),病程中出现症状加重更多见(P<0.05),心源性栓塞型占比更高(P<0.05),小动脉闭塞型比例较低(P<0.05),预后良好(mRS评分≤2分)比例更高(P<0.05)。合并多种高危因素(≥3种)、大病灶、并发脑叶梗死及病程有症状加重等因素均与胼胝体梗死的不良预后相关。结论急性胼胝体梗死常损害认知功能,肢体瘫痪相对较轻,容易延误治疗。合并脑叶梗死、大病灶或病程有症状加重等因素均与其不良预后相关。Objective To explore the clinical characteristics and prognostic analysis of acute corpus callosum infarction.Methods A total of 1466 patients with acute cerebral infarction admitted to the Neurology Department of Jiangbin Hospital in Guangxi from January 2019 to October 2023 and Neurology Department of Fuwai Hospital,Chinese Academy of Medical Sciences from January 2022 to December 2022.Among them,21 patients with acute corpus callosum infarction confirmed by MRI(observation group)and 25 patients with isolated subcortical infarction at the same period(control group)were selected.By comparing clinical data and follow-up information between two groups,we summarized the clinical characteristics of acute corpus callosum infarction,and analyzed the relevant factors affecting the prognosis of the corpus callosum infarction group.Results Acute corpus callosum infarction accounted for 1.43%(21/1466)of patients with acute cerebral infarction in the same period.The main clinical manifestations include limb paralysis,cognitive decline,and speech impairment.Compared with the control group,the group with corpus callosum infarction had a longer onset visit time(P<0.05),more cognitive impairment(P<0.05),a higher proportion of mild stroke(P<0.05),more worsening symptoms during the course of the disease(P<0.05),a higher proportion of cardioembolic type(P<0.05),a lower proportion of small artery occlusion type(P<0.05)and a higher proportion of good prognosis(mRS score≤2 points)(P<0.05).The poor prognosis of corpus callosum infarction was found to be related to factors such as large lesions,multiple high-risk factors(≥3),concomitant lobar infarction and worsening of symptoms during the course of the disease.Conclusions Acute corpus callosum infarction often leads to cognitive impairment and mild limb paralysis,which frequently delays treatment.The poor prognosis is mainly related to factors such as lobar infarction,major lesions,and worsening of symptoms during the process.

关 键 词：胼胝体梗死 临床特征 病因分型 预后 

分 类 号：R743[医药卫生—神经病学与精神病学]