症状性颈内动脉闭塞的临床表现和短期随访  

Clinical features and short-term following-up study of symptomatic internal carotid artery occlusion

作　　者：任士卿[1] 刘俊艳[1] 王瑜玲[1] 张彦[1] 

机构地区：[1]河北医科大学第三医院神经内科,河北石家庄050051

出　　处：《临床荟萃》2003年第21期1207-1209,共3页Clinical Focus

摘　　要：目的　探讨症状性颈内动脉 (ICA)闭塞的临床表现和短期预后。方法　从 80 2例住院的缺血性脑血管病患者中使用经颅多普勒超声 (TCD)和磁共振血管成像 (MRA)检查中发现 2 1例ICA闭塞患者 ,分析他们的临床和影像学表现 ,并进行短期随访。结果　症状性ICA闭塞占住院缺血性脑血管病患者的 2 .6 % ,其中短暂性脑缺血发作(TIA)占 14 % ,脑梗死为 86 % ;影像学检查发现皮层下、分水岭性、皮层和大面积脑梗死分别占 4 3%、2 3.8%、14 %、9.5 %。平均随访 2 1.7个月 ,总脑血管事件发生率为 31.6 % ,年脑血管事件发生率为 17.5 % ,卒中发生率为 15 .8% ,年卒中率为 8.7%。结论　症状性ICA闭塞临床表现多种多样 ,以皮层下和分水岭性脑梗死多见。即使药物治疗 。Objective To study the clinical characteristics and short term prognosis in patients with symptomatic internal carotid artery(ICA) occlusion.Methods Of 802 consecutive patients admitted for an acute ischemic event during 2 year period,21 had ICA occlusion diagnosed by TCD and MRA.Clinical findings of patients and stroke patterns were noted and analysed.The patients were observed prospectively for a mean of 21.7 months.Results 2.6 % had ICA occlusion. 14% were associated with transient ischemic attacks(TIA) and 86% with strokes. The prevalence of subcortical infarct,border zone infarct,cortical infarct and large territorial infarct were 43%, 23.8 %,14% and 9.5 % respectively. During an average follow up period of 21.7 months of 19 patients 31.6 % had cerebrovascular events, the incidence was 17.5 % per year,and the overall incidence of strokes was 15.8 %, 8.7 % per year.Conclusion The clinical findings of symptomatic ICA occlusion are various.symptomatic infarcts related to ICA occlusion are more likely to be subcortical or border zone infarcts.The incidence of stroke is high after ICA occlusion.

关 键 词：症状性颈内动脉闭塞性疾病 临床表现 脑梗塞 短期随访 

分 类 号：R743.3[医药卫生—神经病学与精神病学]