摘要
目的探讨脑梗死后再发缺血性卒中与脑出血患者的临床特点、影像学上微血管病变及预后的异同。方法连续收集急性复发性卒中的住院病例(初发事件为脑梗死,复发事件包括脑梗死或脑出血),详细记录临床资料,观察脑内微出血及白质病变的严重程度,随访有无严重血管事件及死亡的发生。结果175例再发脑梗死患者,19例复发事件为脑出血的患者进入本研究。155例(88.6%)再发脑梗死患者,以及18例(94.7%)脑出血患者存在白质病变。77例(44%)再发脑梗死患者和16例(84.2%)脑出血患者存在脑内微出血。脑出血组白质病变的严重程度及微出血的数目均明显高于再发脑梗死组(P=0.033,0.016),脑出血组的死亡率及再发脑出血的危险性明显增高(P=0.034,0.036)。结论严重的脑白质病变及微出血的出现与脑梗死后再发脑出血有关,多发微出血提示出血风险增高。如复发事件为脑出血,则其死亡率及再次复发脑出血的风险均明显增加。
[Objective] To investigate the clinical features, severity of small vessel disease and prognosis of patients with recurrent stroke. [ Method] In-patients with recurrent stroke （both isehemic and hemorrhagic）, were recruited consecutively. The clinical data was recorded. Microbleed and white matter change on MRI were evaluated. Then the patients were followed up for severe vascular events or death. [Result] One hundred and seventy-five patients with recurrent isehemic stroke and 19 patients with intracerebral hemorrhage were included in the study. White matter change was found in 173 patients （155 vs 18）, and microbleed was found in 93 patients （77 vs 16）. Score of white matter change and number of microbleed were found different between the two groups （P= 0.033, 0.016）. There was also a significant difference between the two groups in developing further intracerebral hemorrhage or death（P=0.034, 0.045）. [Conclusion] Severe white matter change and presence of microbleed were associated with further intracerebral hemorrhage among patients with ischemic stroke, which may predict higher mortality and poorer prognosis.
出处
《中山大学学报（医学科学版）》
CAS
CSCD
北大核心
2006年第3期346-349,共4页
Journal of Sun Yat-Sen University:Medical Sciences
关键词
脑梗死
脑出血
核磁共振成像
微出血
白质病变
cerebral infarction
cerebral hemorrhage
magnetic resonance imaging
microbleed
white matter change
