摘要
目的探讨颅内供血动脉夹层性脑梗死(IFAD)和大动脉粥样硬化性脑梗死(LAA)的临床特点及脑血管造影(DSA)病变血管异同。方法选取2011年7月至2015年9月该院的急性脑梗死患者分为LAA组和IFAD组作为研究对象,采用回顾性分析统计患者临床资料、DSA血管差异和脑血管病的常见危险因素。结果两组临床表现相似,均以卒中样表现起病,但IFAD组出现头痛或颈痛比例更高,LAA组中糖尿病比例更高;LAA组空腹血糖、糖化血红蛋白及低密度脂蛋白胆固醇(LDL-C)水平较IFAD组更高,尤其是LAA组中的重度狭窄者。DSA显示两组病变血管累及前循环为主,以重度狭窄多见;IFAD以颅外、单支血管受累为主,常见的血管损伤为颈内动脉、椎动脉;LAA组以颅内、多支血管受累多见,常见受累血管为颈内动脉、大脑中动脉、椎动脉、基底动脉。结论空腹血糖、糖化血红蛋白和LDL-C水平高的脑梗死可能提示为LAA,尤其是LAA中的重度狭窄者。IFAD多为单支重度狭窄,LAA多为多支中重度狭窄。头痛或颈痛是IFAD和LAA鉴别的重要提示症状。
Objective To investigate the clinical characteristics of intracranial feeding artery dissection（IFAD）cerebral infarction and large-artery atherosclerosis（LAA）cerebral infarction and the similarities and differences of lesion vessels by the digital subtraction angiography（DSA）.Methods The patients with acute cerebral infarction in the hospital from July 2011 to September2015were selected as the research subjects and divided into the LAA group and IFAD group.The clinical data,DSA vessels differences and common risk factors of cerebral diseases were retrospectively performed the statistical analysis.Results The two groups were similar in clinical manifestations and both started with stroke-like episodes.But the proportion of headache or neck pain in the IFAD group was higher,whereas the proportion of diabetes in the LAA group was higher.The levels of fasting blood glucose,glycosylated hemoglobin and LDL-C in the LAA group were significantly higher than those in the IFAD group,especially in the patients with severe stenosis of the LAA group.The DSA revealed that the lesion vessel in the two groups mainly involved in anterior circulation,the severe stenosis was common.The extracranial single vascular involvement in the IFAD group was predominant,the common vascular lesions were the internal carotid artery and vertebral artery;in the LAA group,the intracranial multivessels involvements were predominant,which were the internal carotid artery,middle cerebral artery,vertebral artery and basilar artery.Conclusion The high levels of fasting blood glucose,glycosylated hemoglobin and LDL-C in cerebral infarction may suggest LAA,especially severe stenosis in LAA.IFAD is mainly severe stenosis of single vessel.Headache or neck pain is an important prompt symptom to identify IFAD and LAA.
出处
《检验医学与临床》
CAS
2017年第19期2874-2876,共3页
Laboratory Medicine and Clinic
关键词
脑梗死
大动脉粥样硬化
脑动脉夹层
危险因素
脑血管造影
cerebral infarction
large-artery atherosclerosis
cerebral artery dissection
risk factor
cerebral angiography
