摘要
目的探讨急性小脑深部小梗死患者临床及影像特点与发病机制的关系。方法连续收集2015年4月~2017年4月在辽宁省人民医院神经内科住院的急性小脑小梗死患者95例,根据梗死部位分为深部梗死组20例及皮质梗死组75例,比较2组临床及影像特点。结果深部梗死组腔隙性脑梗死评分、脑白质疏松评分及脑微出血发生率较皮质梗死组明显升高[2(1,2)分vs 1(0,1)分,P=0.001;3(2,4)分vs 1(1,2)分,P=0.000;30.0%vs6.7%,P=0.041],心房颤动、颈动脉及椎基底动脉系统粥样硬化发生率较皮质梗死组明显降低(5.0%vs 30.7%,P=0.040;15.0%vs 40.0%,P=0.037;20.0%vs 60.0%,P=0.001)。深部梗死组小动脉病变型发生率明显高于皮质梗死组,动脉粥样硬化血栓型、心源性栓塞型发生率明显低于皮质梗死组,差异有统计学意义(P<0.05,P<0.01)。多因素回归分析显示,腔隙性脑梗死评分和脑微出血是深部梗死的独立危险因素(OR=3.233,95%CI:1.538~6.795,P=0.002;OR=8.123,95%CI:2.182~5.301,P=0.009),且深部梗死与小动脉病变型呈正相关(OR=5.481,95%CI:1.811~19.815,P=0.006)。结论小脑深部小梗死可能由脑小血管病变引起。
Objective To study the relationship of clinical and radiological characteristics with the pathogenesis of acute small deep cerebellar infarction（SDCI）.Methods Ninety-five patients with acute small cerebellar infarction admitted to our hospital from April 2015 to April 2017 were divided into deep cerebellar infarction（DCI）group（n=20）and cortical infarction group（n=75）.Their clinical and imaging characteristics were compared.Results The lacunar infarction score,leukoararaiosis score and microbleeds score were significantly higher[2（1,2）score vs 1（0,1）score,P=0.001;3（2,4）score vs 1（1,2）score,P=0.000;30.0% vs 6.7%,P=0.041]while the incidence of AF and carotid or basilar artery atheromatous sclerosis was significantly lower（5.0%vs30.7%,P=0.040;15.0% vs 40.0%,P=0.037;20.0% vs 60.0%,P=0.001）,the incidence of small artery lesions was significantly higher while that of atherosclerotic and cardiogenic thrombosis was significantly lower in DCI group than in cortical infarction group（P〈0.05,P〈0.01）.Multivariate logistic regression analysis showed that lacunar cerebellar infarction and cerebral microbleeds were the independent risk factors for DCI（OR=3.233,95%CI：1.538-6.795,P=0.002;OR=8.123,95%CI：2.182-5.301,P=0.009）and that DCI was positively related with small artery lesions（OR=5.481,95%CI：1.811-19.815,P=0.006）.Conclusion SDCI is induced by small vessel lesions.
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2018年第1期71-74,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
关键词
脑梗死
脑白质疏松症
脑出血
心房颤动
动脉粥样硬化
危险因素
brain infarction
leukoaraiosis
cerebral hemorrhage
atrial fibrillation
atherosclerosis risk factors
