摘要
目的探讨颅内大动脉狭窄与腔隙性脑梗死之间的关系,以进一步阐明腔隙性脑梗死的发病机制。方法对216例腔隙性脑梗死患者进行MRI+MRA检查、NIHSS评分,同时记录出现进展性脑卒中的情况。分析颅内大动脉狭窄与腔隙性脑梗死发生的关系,以及其对进展性卒中发生的影响。结果 MRA显示:216例腔隙性脑梗死患者中65例存在颅内大动脉狭窄(30.1%)。其中23例为单一血管狭窄,42例为多发颅内大动脉狭窄。狭窄的动脉分布为大脑中动脉(61/111,55.0%)、大脑后动脉(15/111,13.5%)、大脑前动脉(13/111,11.7%)、颈内动脉颅内段(12/111,10.8%)、基底动脉(6/111,5.4%)、椎动脉颅内段(3/111,2.7%)。1级狭窄占51.4%,2级狭窄占39.6%,3级及以上狭窄的占9.0%。入院后1周内20例患者出现了进展性卒中。在此类患者中,颅内动脉达到1级狭窄的患者有22.3%,达到2级狭窄的有41.7%,达到3级及以上狭窄的有36.0%。进行统计分析结果为腔隙性脑梗死病灶所处解剖区的供血动脉更易发生狭窄(占所有颅内动脉狭窄患者的67.7%)(P<0.01),而且此类患者更容易出现进展性卒中(进展性卒中发生率为36.4%)(P<0.01)。结论腔隙性脑梗死病灶所处解剖区的供血大动脉更易发生狭窄,其可能是腔隙性脑梗死发生的重要机制,这种患者更加容易出现进展性卒中,需要更积极的临床治疗。
Objective To further elucidate the potential mechanism of lacunar infarction from studing the relationship between intracranial artery stenosis and lacunar infarction.Methods 216 patients of lacunar infarction were performed with MRI＋MRA and completed NIHSS score,those had a progressive onset were recorded.The data were used to analyse the relationship between intracranial artery stenosis and lacunar infarction,and assess its impact on the onset of progressive stroke.Results 65 subjects with intracranial artery stenosis were found in 216 patients with lacunar infarction（30.1%）,being composed of 23 subjects with simplex artery stenosis and 42 subjects with complex artery stenosis.The artery stenosis distributed in middle cerebral atery（61/111,55.0%）,posterior cerebral artery（15/111,13.5%）,anterior cerebral artery（13/111,11.7%）,Intracranial internal carotid artery（12/111,10.8%）,basilar artery（6/111,5.4%）,Intracranial vertebral artery（3/111,2.7%）.The incidence of intracranial artery stenosis in grade 1,grade 2,grade 3 and above was 51.4%,39.6% and 9.0%,respectively.In the first week from the admission,20 patients had progressive stroke,differently in these persons,the incidence of intracranial artery stenosis in grade 1,grade 2 and grade 3 and above was 22.3%,41.7% and36.0%%,respectively.Statistical analysis：in patients with intracranial artery stenosis,proportion of persons with stenosis in intracranial large arteries which perfuse for the anatomical region where infartion located was significant higher（67.7%）（P〈0.01）,and these patients were more likely to have progressive stroke（incidence：36.4%）（P〈0.01）.Conclusion stenosis were more easily to happen in the intracranial large arteries which perfuse for the anatomical region where infartion located,and that may be an important mechanism account for lacunar infarction.These patients were more likely to have a progressive stroke and may benefit from an active treatment.
出处
《广州医药》
2011年第1期26-28,共3页
Guangzhou Medical Journal
关键词
颅内大动脉狭窄
腔隙性脑梗死
磁共振血管造影
进展性卒中
Intracranial large artery stenosis
Lacunar infarction
Magnetic resonance angiograghy
Progressive stroke
