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1、中國心血管雜志2014年4月第19卷第2期ChinJCardiovascMed,April2014,Vo1.19,No.2·101·.臨床研究.后循環(huán)腦梗死的臨床特點及相關(guān)危險因素分析陳玉輝王音徐蕾李偉羅瑞龔濤盧桂靜【摘要】目的分析后循環(huán)腦梗死的臨床表現(xiàn)、病變部位和危險因素,為預(yù)測后循環(huán)腦梗死的預(yù)后,并進(jìn)一步為預(yù)防后循環(huán)腦梗死的發(fā)生和發(fā)展提供科學(xué)依據(jù)。方法前瞻性研究收集自2011年1月至2012年12月共110例后循環(huán)腦梗死患者的臨床資料,分析癥狀和體征的出現(xiàn)頻率,記錄病變部位和危險因素,推測后循環(huán)腦梗死的病因。結(jié)果后循環(huán)腦梗死患者的年齡39~92歲。平均(68.1±11.9)歲,男
2、性患者占66.4%。后循環(huán)腦梗死最常見的癥狀為頭暈/眩暈(69.1%),肢體無力(47.3%),一般常見的癥狀為言語不清(29.1%),行走不穩(wěn)(26.4%)和吞咽困難/飲水嗆咳(24.5%)。最常見的體征為肢體癱瘓(55.5%),Babinski征/Chaddock征陽性(47.3%),共濟(jì)失調(diào)(42.7%),中樞性面癱(40.0%)和感覺減退(30.0%)。后循環(huán)腦梗死的危險因素有高血壓(76.4%),糖尿病(44.5%),吸煙(42.7%),血脂異常(34.5%)和冠心病(26.4%)。病變部位以腦干病變最多(40.9%),其次為后循環(huán)供血區(qū)多發(fā)性腦梗死(31.8%)。大動脈硬
3、化是后循環(huán)腦梗死主要的病因,顱內(nèi)動脈狹窄(33.6%)和顱外動脈狹窄(34.5%)較常見。結(jié)論后循環(huán)腦梗死最常見的癥狀和體征是頭暈/眩暈,肢體癱瘓,危險因素是高血壓、糖尿病、吸煙、血脂異常和冠心病,腦干梗死最常見,顱內(nèi)外大動脈病變是主要的病因?!娟P(guān)鍵詞】后循環(huán)腦梗死;體征和癥狀;危險因素;病灶ClinicalmanifestationsandriskfactorsinposteriorcirculationischemicstrokeChenYuhui,Wangn,,LiWei,LuoRui,GongTao,LuGuijing.JDepartmentofNeurology,Beiji
4、ngHospital,MinistryofHealth,Beijing100730,China;2DepartmentofCardiovascularMedicine,XiangyaHospital,CentralSouthUniversityCorrespondingauthor:幾gTao,Email:gb20598@sino.com【Abstract】objectiveToinvestigatetheclinicalcharacteristicsandriskfactorsofposteriorcirculationischemicstroke(PCI).MethodsThis
5、wasaprospectivestudyinvolved110PCIpatientsfromJanuary2011toDecember2012.Thefrequenciesofvarioussymptomsandsigns,theriskfactors,lesionslocationandpossiblemechanismofPC1wereanalyzed.ResultsPatientsagedfrom39to92withaverage(68.1±11.9)yearsold,andmalesaccountedfor66.4%.ThemostcommonsymptomsinPC1wer
6、edizziness/venig0(69.1%),limbsweakness(47.3%),andthenweredysarthria(29.1%),unsteadiness(26.4%)anddysphagia(24.5%).Themostcommonsignswerelimbsparalysis(55.5%),Babinskisign/Chaddocksign(47.3%),ataxia(42.7%),centralfacialpalsy(40.O%)andhypesthesia(30.0%).TheriskfactorsforPC1werehypertension(76.4%)
7、,diabetesmellitus(44.5%),smoking(42.7%),hyperlipidemia(34.5%)andcoronaryheartdisease(26.4%).Lesionsatbrainstemweremostcommon(40.9%)andthenweremultiplelesions(31.8%).Intracranialandextracranialarterystenosiswascomparable(33.6%VS.34