摘要
目的研究基底动脉(BA)严重狭窄或闭塞所致脑梗死的临床表现,并评估其预后,分析与预后不良的相关因素。方法收集168例后循环缺血脑梗死患者病例,经全脑动脉造影筛选出29例BA严重狭窄或闭塞病变患者,MRI证实存在BA供血区新鲜脑梗死;随访1年,分析与预后不良相关的临床及血管病变特点。结果21例患者病前有以眩晕发作为主要表现的短暂性脑缺血发作(TIA);发病72h内出现意识障碍者9例,其中4例死亡,5例严重残障。1年病死率为44.8%(14例),严重残障率为13.8%(3例);狭窄位于BA近1/3段6例,中1/3段11例,远1/3段4例;9例入院时NIHSS≥14分的患者3例死亡,6例严重残障。结论BA严重病变所致脑梗死临床预后较差。频繁出现且持续时间逐渐延长的眩晕、早期出现意识障碍可能提示预后不良。NIHSS评分有助于判断预后。
Objective To study the clinical features, evaluate the prognosis and analysis the related factors of poor outcome of patients with severe stenosis or occllusion of basilar arteries. Methods 168 patients with vertebrobasilar infarction admitted in 2003, were enrolled in this study. Severe stenosis or occlusion of basilar arteries of 29 patients were confirmed by DSA and they are followed-up for one year after the onset to assess the clinical and vascular features that might be related to poor outcomes. Results Twenty-one patients had vertigo attacks before cerebral infarction, the most frequent lesions were located at the middle 1/3 of the basilar artery. The mortality rate was 44.4% and the rate of major disability was 13.8% one year after onset, and patients with NIHSS ≥ 14 were more likely to have a poor outcome. Conclusions Patients with cerebral infarction in basilar arteries with severe damages have poor outcome. Vertigo occures frequently, the status of consciousness at the initial stage predicts for the outcome. Evaluation of NIHSS can be used to evaluate the prognosis.
出处
《北京医学》
CAS
2007年第3期132-134,共3页
Beijing Medical Journal
关键词
基底动脉
脑梗死
危险因素
预后
Basilar artery Cerebral infarction Risk factor Prognosis
