摘要
目的探讨急性脑干梗死患者临床特点、危险因素及血管病变特点。方法回顾性收集2013年8月至2016年3月首都医科大学附属北京友谊医院收治的165例急性脑干梗死患者的临床资料及头颈部CT血管成像(CTA)结果。分析比较脑干梗死的临床特点、危险因素及血管病变特点。结果①脑干梗死的最常见危险因素依次为高血压(83. 03%)、吸烟(55. 76%)、糖尿病(50. 91%)、高脂血症(50. 30%)和饮酒史(47. 88%)。各项危险因素在不同梗死部位患者之间差异无统计学意义(P> 0. 05)。②脑干梗死常见症状和体征依次为肢体无力(69. 70%)、头晕/眩晕(58. 79%)、感觉障碍(41. 82%)、共济失调(35. 15%)和构音障碍(34. 55%)。③脑干梗死多发于脑桥(73. 94%),其次为延髓(10. 91%)、中脑(4. 85%);合并脑干外多病灶患者占10. 91%。④头颈部CTA结果显示,165例患者中,椎动脉狭窄患者79例,占47. 88%;基底动脉狭窄患者13例,占7. 88%;椎动脉发育不良患者30例,占18. 18%。不同梗死部位患者椎动脉狭窄及椎动脉发育不良发生率差异无统计学意义(P> 0. 05)。基底动脉狭窄发生率在不同梗死部位患者中差异具有统计学意义(P <0. 05)。结论脑干梗死最易发生于脑桥,其最常见的危险因素是高血压。脑干不同部位梗死的患者基底动脉狭窄发生率有显著差异。
Objective To investigate the clinical characteristics,risk factors and cerebrovascular features in patients with actue brainstem infarction. Methods Clinical data and head-neck CTA results of 165 patients with actue brainstem infarction from August 2013 to March 2016 in Beijing Friendship Hospital,Capital Medical University were retrospectively collected. Clinical characteristics,risk factors and cerebrovascular features of patients with brainstem infarction were compared and analyzed. Results ①The most common risk factors for brainstem infarction were hypertension( 83. 03%),smoking( 55. 76%),diabetes( 50. 91%),hyperlipidemia( 50. 30%),and drinking history( 47. 88%). There was no statistically significant difference in risk factors between different infarction sites( P > 0. 05) . ② The most common symptoms and signs of brainstem infarction were limb weakness( 69. 70%),dizziness/vertigo( 58. 79%),sensory disturbance( 41. 82%),ataxia( 35. 15%) and dysarthria( 34. 55%) . ③Brainstem infarction mostly occurred in pons( 73. 94%),followed by medulla( 10. 91%) and midbrain( 4. 85%). Patients with multiple lesions outside the brainstem accounted for 10. 91% . ④Head-neck CTA results of 165 patients showed 79 cases of vertebral artery stenosis( 47. 88%),13 cases of basilar artery stenosis( 7. 88%) and 30 cases of vertebral artery dysplasia( 18. 18%). There was no significant difference in the incidence of vertebral artery stenosis and vertebral artery dysplasia between different infarction sites( P > 0. 05). However,the incidence of basilar artery stenosis was significantly different between patients with different infarction sites( P < 0. 05). Conclusion Brainstem infarction is most likely to occur in the pons,and the most common risk factor is hypertension. The incidence of basilar artery stenosis was significantly different between patients with different infarction sites in the brainstem.
作者
韩春玉
杨颖
张拥波
HAN Chun-yu;YANG Ying;ZHANG Yong-bo(Department of Neurology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)
出处
《临床和实验医学杂志》
2020年第4期360-363,共4页
Journal of Clinical and Experimental Medicine
基金
国家自然科学基金(编号:81371355)
