摘要
目的分析分水岭脑梗死（WSI）的危险因素及病因。方法 2012年10月-2014年5月连续收集入住航天中心医院神经内科的WSI患者86例（WSI组）,同期选择年龄、性别相匹配的非WSI的脑梗死患者86例（非WSI组）,比较两组临床资料及影像学特点。结果 WSI组糖尿病、低灌注比例高于非WSI组（P=0.024、0.043）,收缩压、平均动脉压水平均低于非WSI组（P=0.016、0.030）;WSI组皮层小梗死发生比例、大脑中动脉及颈内动脉中重度狭窄或闭塞比例、前/后交通动脉均不开放比例均高于非WSI组（P=0.000、0.016、0.007、0.021）;前/后交通动脉均开放比例低于非WSI组（P=0.033）。结论 WSI发生的危险因素有糖尿病、低灌注及低血压,发病原因为脑动脉中重度狭窄或闭塞和低灌注事件所致的血流动力学障碍、微栓塞、Willis环血流代偿。
Objective To investigate the etiology and risk factors for watershed cerebral infarction（WSI） and to provide the theoretical basis for the prevention and treatment. Methods Eighty-six patients with WSI were recruited from October 2012 to May 2014 in department of neurology of Aerospace Center Hospital,over the same period selected age and sex matched 86 non-WSI persons as control group. Clinical and demographic features and neuroradiological features were compared between two groups. Results Compared with the non-WSI group,WSI group had a higher incidence of diabetes mellitus and hpoperfusion events（P = 0. 024 and P = 0. 043,respectively）. However,WSI group had lower levels of average systolic blood pressure and mean arterial blood pressure than non-WSI group（P = 0. 016 and P = 0. 030,respectively）. WSI group had a higher rates of small cortical infarcts,moderate to severe stenosis or occlusion in the middle cerebral artery and internal carotid,and no displaying of anterior and posterior communicating artery than non-WSI group（ P =0. 000,0. 016,0. 007,0. 021,respectively）. The openness rate of both anterior and posterior communicating artery in WSI group is lower than that in non-WSI group（P = 0. 033）. Conclusions Hemodynamic compromise caused by moderate to severe stenosis or occlusion of cerebral arteries or hypoperfusion,microembolization and the colleteral ability of Willis circle may be all involved in the occurrence of WSI.
出处
《山东医药》
CAS
2014年第40期19-21,共3页
Shandong Medical Journal
基金
中国航天科工集团第二研究院青年创新基金项目(2013年12号)
关键词
分水岭脑梗死
血流动力学障碍
微栓塞
大脑动脉环
危险因素
watershed cerebral infarction
hemodynamic compromise
microembolic
Willis circle
pathogenesis
