摘要
目的探讨儿童动脉缺血性卒中(AIS)的起病方式、梗死部位与卒中病因的关系。方法回顾性分析1997年1月-2007年10月在武汉市儿童医院及华中科技大学同济医学院附属同济医院儿科住院、经头颅影像学证实并诊断为AIS的病例97例。年龄6个月～18岁。按病因分为炎性反应性动脉病组(32例)与非炎性反应性动脉病组(65例)(脑血管畸形、心源性栓塞、血液系统疾病及代谢疾病)。记录二组患儿年龄、起病方式及梗死部位,并将起病方式分为急性与非急性,梗死部位分为基底核区与大脑中动脉主干供血区。采用t检验比较二组AIS患儿平均年龄差异,χ2检验比较二组患儿起病方式与梗死部位差异。结果炎性反应性动脉病组与非炎性反应性动脉病组平均年龄比较差异无统计学意义(t=1.573P>0.05)。炎性反应性动脉病组中急性起病者10例(31.2%),非炎性反应性动脉病组中急性起病者38例(58.5%),二组比较差异有统计学意义(χ2=6.352P<0.05)。炎性反应性动脉病组梗死灶位于基底核区21例(65.6%),非炎性反应性动脉病组梗死灶位于基底核区28例(43.1%),二组比较差异有统计学意义(χ2=4.361P<0.05)。结论起病方式与梗死部位可以提示儿童AIS的病因诊断。非急性起病、梗死灶位于基底核区的AIS,其病因多为炎性反应性动脉病。
Objective To explore the association among temporal features of onset of neurological symptoms, infarction site and stroke etiology in children with arterial ischemie stroke （AIS）. Methods Ninety - seven hospitalized children（aged 6 months to 18 years old） with a confirmed diagnosis of AIS from Jan. 1997 to Oct. 2007 in Wuhan Children＇s Hospital and Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology were retrospectively reviewed. They were divided into cerebral inflammatory arteriopathy group andnoninflammatory arteriopathy group （dissection, cardioembolic, hematologic and metabolic disease）. Medical charts were recorded for age, mode of onset and location of infarction. The onset as either abrupt or nonabrupt and the location as basal ganglia or middle cerebral artery bole territory were classified. Then the average age, the mode of onset and the location of infarction in patients with known cerebral inflammatory arteriopathy were compared with those with noninflammatory arteriopathic stroke using t test or χ^2 test. Results The average age had no significant difference between the inflammatory and noninflammatory arteriopathic groups （ t = 1. 573 P 〉 0.05 ）. The abrupt onset of the inflammatory arteriopathy group was 10 cases （31.2% ） , the abrupt onset of the noninflammatory arteriopathy group was 38 cases （58.5%） ,there was significant difference for the mode of onset between the 2 groups （χ^2 = 6. 352 P 〈 0.05 ） ,the infarction in basal gangia of the inflammatory arteriopathy group 21 cases （65.6%） ,the infarction in basal gangia of the noninflammatory arteriopathy group 28 cases （43.1% ）, there was significant difference in the infarction site between the 2 groups （χ^2= 4. 361 P 〈 0.05 ）. Conclusions Mode of onset and infarction site predict etiological diagnosis of childhood AIS. A nonabrupt onset of symptoms and the infarction in basal ganglia is associated with cerebral inflammatory arteriopathy.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2008年第24期1906-1907,共2页
Journal of Applied Clinical Pediatrics
基金
武汉市卫生局2007年临床医学科研项目资助(武卫2007-43号)
关键词
动脉缺血性卒中
起病方式
梗死部位
病因诊断
儿童
arterial ischemic stroke
mode of onset
infarct location
etiological diagnosis
child
