本文選題：腦梗死 + 栓塞��； 參考：《中國神經(jīng)精神疾病雜志》2016年08期

【摘要】：目的研究高凝狀態(tài)相關(guān)性非單一動脈供血區(qū)多發(fā)急性腦梗死的臨床和影像學(xué)特點、微栓子監(jiān)測,探討其可能的發(fā)病機(jī)制。方法收集就診于我院神經(jīng)內(nèi)科的高凝狀態(tài)相關(guān)性非單一動脈供血區(qū)多發(fā)急性腦梗死患者的臨床資料、實驗室檢查、頭MRI、TCD微栓子監(jiān)測,總結(jié)分析其特點。結(jié)果共收集22例患者。均以局灶性神經(jīng)功能缺損急性起病,包括偏癱、失語、偏身感覺障礙、構(gòu)音障礙、偏盲、皮質(zhì)盲。高凝狀態(tài)相關(guān)性基礎(chǔ)疾病如下:系統(tǒng)性惡性腫瘤10例,高同型半胱氨酸血癥(中重度,HCY50μmol/L)5例,腎病綜合征2例,抗磷脂綜合征2例,潰瘍性結(jié)腸炎1例,真性紅細(xì)胞增多癥1例,陣發(fā)性睡眠性血紅蛋白尿癥1例。18例在卒中發(fā)病后高凝狀態(tài)相關(guān)性基礎(chǔ)疾病才被首次確診。DWI示多發(fā)急性梗死灶,不符合單一動脈供血區(qū),累及雙側(cè)前循環(huán)或前后循環(huán),病灶累及大腦半球腦葉皮層/皮層下22例,深部12例,小腦10例,腦干2例。22例行微栓子監(jiān)測者10例陽性。結(jié)論對于非單一動脈供血區(qū)多發(fā)急性腦梗死,要注意篩查高凝狀態(tài)相關(guān)性基礎(chǔ)疾病,高凝狀態(tài)和微栓塞可能都參與其發(fā)病機(jī)制。
[Abstract]:Objective to study the clinical and imaging features of multiple acute cerebral infarction (ACI) in hypercoagulant state associated with non-single artery supply area, and to investigate the possible pathogenesis of hypercoagulation-related acute cerebral infarction (ACI) by monitoring microemboli. Methods the clinical data, laboratory examination and TCD microemboli monitoring of multiple acute cerebral infarction patients with hypercoagulant state associated with non-single artery blood supply were collected and analyzed in our department of neurology. Results A total of 22 patients were collected. All patients had acute onset of focal neurological deficit, including hemiplegia, aphasia, hemiplegia, dysarthria, hemianopsia and cortical blindness. The basic diseases associated with hypercoagulability were as follows: 10 cases of systemic malignant tumor, 5 cases of hyperhomocysteinemia (moderate and severe HCY 50 渭 mol / L), 2 cases of nephrotic syndrome, 2 cases of antiphospholipid syndrome, 1 case of ulcerative colitis, 1 case of true polycythemia. One case with paroxysmal nocturnal hemoglobinuria. 18 cases with hypercoagulation-related basic diseases after stroke were first diagnosed. DWI showed multiple acute infarct foci, which did not accord with single artery supply area and involved bilateral anterior circulation or anterior and posterior circulation. There were 22 cases of cerebral hemispheric cortex / subcortical involvement, 12 cases of deep cerebral cortex, 10 cases of cerebellum and 2 cases of brain stem. 10 cases were positive for microemboli monitoring. Conclusion for multiple acute cerebral infarction in non-single arterial blood supply area, attention should be paid to screening basic diseases associated with hypercoagulability. Hypercoagulability and microembolism may be involved in the pathogenesis of cerebral infarction.
【作者單位】： 北京大學(xué)第一醫(yī)院神經(jīng)內(nèi)科;
【分類號】：R743.3

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