高齡后循環(huán)腦梗死患者的臨床特點(diǎn)分析-論文.pdf

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1、·83O·中華老年心腦血管病雜志2014年8月第l6卷第8期ChinJGeriatrHeartBrainVesselDis，Aug20l4，Vol16，No．8臨床研究．高齡后循環(huán)腦梗死患者的臨床特點(diǎn)分析劉猛，吳堅(jiān)，盛世英，練學(xué)淦，唐曉春，姜晴睛，陳利民摘要：目的探討高齡后循環(huán)腦梗死患者的發(fā)病危險(xiǎn)因素、臨床表現(xiàn)、影像學(xué)特點(diǎn)和預(yù)后。方法選擇522例老年急性后循環(huán)腦梗死患者，依據(jù)年齡分為高齡組152例(≥8O歲)和老年組370例(60～79歲)。比較2組患者的臨床癥狀、影像學(xué)資料和發(fā)病危險(xiǎn)因素，并在病后30d進(jìn)行改

2、良Rankin量表評(píng)估分析預(yù)后。結(jié)果與老年組比較，高齡組頭暈和雙側(cè)肢體乏力、心房顫動(dòng)比例明顯升高(42．11VS29．73、7．89WS3．24、17．11VS10．00，P<0．05，P<0．01)。高齡組最常累積后循環(huán)血管的中段和遠(yuǎn)段。與老年組比較，高齡組枕葉單發(fā)梗死和多發(fā)梗死明顯升高；預(yù)后不良比例明顯升高(28．29VS17．57，P<0．01)。結(jié)論高齡后循環(huán)腦梗死患者在發(fā)病危險(xiǎn)因素、臨床表現(xiàn)以及影像學(xué)特點(diǎn)均與老年后循環(huán)腦梗死患者存在差異，高齡后循環(huán)腦梗死患者預(yù)后相對(duì)較差。關(guān)鍵詞：腦梗死；頭暈；心房顫動(dòng)

3、；枕葉；危險(xiǎn)因素；預(yù)后Clinicalcharacteristicsofadvance—agedposteriorcirculationischemicstrokepatientsLIUMeng，WUJian，SHENGShi—ying，etal(Department0／’Neurology，ThirdAffiliatedHospitalofSuzhouUniversity，Changzhou213003，JiangsuProvince，China)Abstract：0bjectiveTostudytheris

4、kfactors，clinicalmanifestations，radiologicalfeaturesandoutcomeofadvance—agedposteriorcirculationischemicstrokepatients．MethodsFivehundredandtwenty——twoposteriorcirculationischemicstrokepatientswiththeirage>／-60yearsweredi—videdinto≥80yearsoldgroup(”===152)an

5、d60—79yearsoldgroup(一370)．Theirriskfac—tors．clinicalmanifestations，radiologicaldataandoutcomewerecomparedaccordingtOthemodi—fledRankinScale(mRS)onday30afteronsetofposteriorcirculationischemicstroke．ResultsTheincidenceofdizziness，bilaterallimbweaknessandatria

6、lfibrillationwassignificantlyhigherin≥80yearsoldgroupthanin60—79yearsoldgroup(42．11VS29．73，7．89"US3．24％，17．11VS10．00，P<0．05，P<0．01)．Themostcommonlyinvolvedwerethemiddleanddistalsegmentsofposteriorcirculationvesselsinadvance·—agedposteriorcirculationischemics

7、trokepa—tients．Occipitallobeinfarctionwasmorecommonandtheoutcomewaspoorerin≥8Oyearsoldgroupthanin60—79yearsoldgroup(28．299／6s17．57，P

8、patientsaredifferentfromthoseofagedposteriorcirculationischemicstrokepatients．Theoutcomeispoorerinadvance—agedposteriorcirculationischemicstrokepatientsthaninagedpos—teriorcirculationischemicstr