摘要
目的通过比较不同类型腔隙性脑梗死（lacunar infarction,LI）与非LI的危险因素,推测其发病机制。方法回顾性分析2008年8月1日~2014年12月13日入住我院的急性颈内动脉系统脑梗死患者的临床资料,根据临床表现及影像学结果筛选出符合入选标准的患者LI 148例和非LI 148例。根据头颅MRI弥散加权成像上病灶数目及位置分为单发LI 113例,多发LI 35例;单发非LI 97例,多发非LI 51例。采用logistic回归分析IL的危险因素。结果单发LI的心房颤动及同侧颈动脉狭窄≥50%的发生率较多发LI（0.88%vs 11.43%,P=0.013;1.77%vs 17.14%,P=0.002）、单发非LI（0.88%vs 11.34%,P=0.001;1.77%vs 16.49%,P=0.000）、多发非LI（0.88%vs 9.80%,P=0.018;1.77%vs 17.65%,P=0.000）明显低。与单发LI比较,心房颤动及同侧颈动脉狭窄≥50%为多发LI（OR=26.353,95%CI：2.778~250.007,P=0.011;OR=11.483,95%CI：2.202~59.891,P=0.011）、单发非IL及多发非IL的独立危险因素。多发LI与单发非IL和多发非LI心房颤动及同侧动脉狭窄≥50%等危险因素无差异（P〉0.05）。结论单发LI与多发LI具有不同的发病机制,推测动脉粥样硬化病变及心源性栓塞为多发性LI的重要发病机制,但参与单发LI发病过程的概率相对较少。
Objective To study the pathogenesis of different lacunar infarction（LI）subtypes by comparing the risk factors for LI and non-LI.Methods Clinical data of acute ischemic stroke patients（148LI patients and 148non-LI patients）admitted to our hospital were retrospectively analyzed.The patients were divided into single LI group（n=113）,multiple LI group（n=35）,single non-LI group（n=97）and multiple non-LI group（n=51）according to their MRI.Risk factors for LI were analyzed by logistic regression analysis.Results The incidence of AF and ipsilateral carotid stenosis≥50% was significantly lower in single LI group than in single non-LI group,multiple LI group and multiple non-LI group（0.88%vs 11.43%,P=0.013;1.77%vs 17.14%,P=0.002;0.88%vs 11.34%,P=0.001;1.77%vs 16.49%,P=0.000;0.88%vs 9.80%,P=0.018;1.77%vs 17.65%,P=0.000）.AF and ipsilateral carotid stenosis ≥50% were the independent risk factors for multiple LI（OR=26.353,95%CI：2.778-250.007,P=0.011;OR=11.483,95%CI：2.202-59.891,P=0.011）.No significant difference was found in risk factors for multiple LI and non-LI（P〈0.05）.Conclusion The pathogenesis of single LI and multiple LI is different.Atherosclerotic lesion and cardiogenic embolism are the important mechanism for multiple LI and are seldom involved in single LI.
出处
《中华老年心脑血管病杂志》
CAS
2016年第9期961-965,共5页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
关键词
脑梗死
动脉粥样硬化
心房颤动
颈动脉狭窄
磁共振成像
危险因素
brain infarction
atherosclerosis
atrial fibrillation
carotid stenosis
magnetic resonance imaging
risk factors
