摘要
目的：急性分水岭区脑梗死（acute border—zone infarcts，ABZI）的发病机制目前尚不明确。我们通过弥散加权成像（diffusion—weighted imaging，DWI）探讨ABZI的病理生理学从而对其进行分类。方法：我们选择105名ABZI患者进行研究。在患者脑梗死症状出现24h之内进行DWI检查。根据动脉支配区特点把ABZI分为内侧BZI（Interal border—zone infarcts，IBZI）与皮层BZI（Cortical border—zone infarcts，CBZI）两组，并分别比较这两组的临床特点和影像学特点。结果：IBZI组有67名患者，CBZI组有38名患者。与CBZI组患者相比，IBZI组患者的大脑中动脉（middle cerebral artery，MCA）的严重狭窄率或闭塞率比率较高，DWI上其梗死灶通常为串珠样（P〈0．01），而CBZI组较多表现为皮层小梗死病变（P〈0．01）。结论：IBZI的病因可能主要为脑动脉血流动力学障碍所致，而栓塞机制是CBZI的主要发病机制。我们的研究结果提示不同类型的ABZI的治疗方案是存在差异的。
OBJECTIVE： To investigate the pathogenesis of acute border- zone infarcts （ABZI）. METHODS： 105 patients with ABZI with a symptomatic lesion detected by DWI within 24 hours of stroke onset were selected. ABZI were divided into interal border- zone infarcts （IBZI） group （67 cases） and cortical border- zone infarcts （CBZI） group （38 cases） based on vascular ter- ritories. Clinical and neuroradiological features were compared between patients with IBZI and CBZI. RESULTS： Compared with the CBZI group IBZI group had a higher degree of stenosis or occlusion in middle cerebral artery （MCA） and exhibited a rosary - like pat- tern of infarction （P 〈 0. 01 ）. And concomitant small cortical infarcts were observed more frequently in CBZI group （ P 〈 0. 01 ）. CONCLUSIONS： IBZI are caused mainly by hemodynamic compromise and embolic pathogenesis appear to contribute greatly to the genesis of CBZI. These suggest that different therapeutic approaches have different effects in patients with different types of ABZI.
出处
《国际老年医学杂志》
2013年第1期7-11,共5页
International Journal of Geriatrics
关键词
分水岭区脑梗死
弥散加权成像
发病机制
血流动力学障碍
栓塞
Border - zone infarction
Diffusion - weighted imaging
Pathogenesis
Hemodynamics compromise
Embolization
