摘要
目的分析中国人脑分水岭梗死相关危险因素,讨论其病理机制,为制定合理的诊疗及二级预防方案提供依据。方法本研究纳入了578例脑梗死患者,将脑分水岭梗死分为内侧型、外侧型和混合型3组,比较各组与非脑分水岭梗死之间一般临床资料及脑血管影像资料之间的统计差异。结果各组资料在年龄、性别、高血压、糖尿病、体循环病变(栓塞)、卒中史、饮酒史、低密度脂蛋白(LDL-c)、总胆固醇(TC)、甘油三酯(TG)、纤维蛋白原(FIB)、椎基底动脉狭窄、大脑后动脉狭窄等方面均无显著统计学差异;高纤维蛋白原血症在内侧型、混合型组中发病率增高,外侧型组高脂血症和混合型组吸烟史、体循环病变(低血容量)发生率增高,而混合型组HDL-c有所下降;脑分水岭梗死平均动脉狭窄数明显增多,大脑中动脉狭窄发生率高达56.7%,外侧型组大脑前动脉及内侧型组颈动脉狭窄率均明显增高。结论中国人脑分水岭梗死主要与大脑中动脉狭窄有关,各型发病机制均有所不同。
Objective By analyzing the risk factors of cerebral watershed infarction （CWI） in Chinese patients,we aim to investigate the pathogenesis and provide evidence for the diagnosis, treatment and secondary prevention. Methods A total of 578 patients with cerebral infarction were included in our study. Patients with cerebral watershed infarction were divided into three subtypes （ internal, external and mixed CWI）. We compared the CWI group with non-cerebral watershed infarction （non-CWI） group. The clinical data as well as vascular images of these groups was analyzed. Results There was no difference between these groups in age, sex, hypertension, diabetes, circulation disorder（ embolism）, history of stroke and drinking, LDL, TC, TG, FIB, stenosis of vertebral basilar artery and posterior cerebral artery. More patients suffered from hyperfibrinogenemia in internal and mixed CWI. The rates of hyperlipidemia in external CWI and smoking history as well as circulation disorder （low blood volume） in mixed CWI had risen while the mean value of HDL-c in mixed-CWI decreased. Obviously, more stenoses were found in CWI and the incidence of MCA stenosis was as high as 56.7%. The stenosis incidence of ACA in external CWI and carotid in internal CWI was higher statistically than non-CWI. Conclusions Cerebral watershed infarction in Chinese patients is mainly associated with middle cerebral artery stenosis, the pathogenesis of its subtypes is also different from each other.
出处
《中风与神经疾病杂志》
CAS
CSCD
北大核心
2014年第6期497-501,共5页
Journal of Apoplexy and Nervous Diseases
基金
国家自然科学基金(No.81200899)
关键词
脑分水岭梗死
危险因素
弥散加权成像
脑血管影像
动脉粥样硬化性狭窄
Cerebral watershed infarction
Risk factors
Diffusion weighed imaging（DWI）
Cerebral vascular image
Atherosclerosis stenosis
