【摘要】：目的分析首發(fā)急性腦梗死中無癥狀腦梗死的患病率、危險(xiǎn)因素、臨床表現(xiàn)、頭部MRI特征及臨床意義。 方法收集2011年3月至2012年12月在吉林大學(xué)第二臨床醫(yī)院住院的首發(fā)急性腦梗死患者130例。所有患者均否認(rèn)既往曾患腦血管病、頭部外傷、占位等病史，均為首次發(fā)生神經(jīng)系統(tǒng)缺失癥狀及體征，且均符合全國(guó)第四屆腦血管病學(xué)術(shù)會(huì)議制定的無癥狀性腦梗死診斷標(biāo)準(zhǔn)，依據(jù)頭部MRI將其分為研究組（同時(shí)存在急性腦梗死責(zé)任病灶與非責(zé)任病灶者）88例，其中男50例，女38例，和對(duì)照組(僅有急性腦梗死責(zé)任病灶者）42例，男32例，女10例。詳細(xì)詢問患者病史、查體，并行血糖、血脂、心電圖、頭部MRI、頭頸部血管超聲等相關(guān)檢查。明確患者的腦血管病的危險(xiǎn)因素，包括年齡、吸煙、飲酒史、血脂、血壓、血糖，有無心房纖顫、動(dòng)脈粥樣硬化斑塊及動(dòng)脈狹窄情況，對(duì)上述危險(xiǎn)因素進(jìn)行統(tǒng)計(jì)分析，比較兩組的危險(xiǎn)因素及臨床意義，并總結(jié)分析研究組臨床表現(xiàn)及頭部MRI特點(diǎn)。 結(jié)果1、首發(fā)急性腦梗死患者中，SCI患病率為67.7%；2、性別：首發(fā)急性腦梗死患者中，男性SCI患病率為61.0%，女性SCI患病率為79.2%，女性SCI的患病率高于男性，且P0.05；年齡：研究組，60的患者比率為49.3%，≥60的患者比率為89.8%，對(duì)照組60的患者比率為50.7%，≥60的患者比率為10.2%，≥60的患者患SCI的比率高于60的患者，且P0.05；3、吸煙、飲酒、高血壓、糖尿病、高脂血癥、心房纖顫：研究組上述危險(xiǎn)因素的比率依次為：55.7%、28.4%、55.7%、23.9%、56.8%、2.3%，對(duì)照組上述危險(xiǎn)因素的比率依次為54.8%、40.5%、42.3%、16.7%、64.3%，7.1%。兩組之間比較P0.05，，均無統(tǒng)計(jì)學(xué)意義；動(dòng)脈狹窄、不穩(wěn)定斑塊：研究組比率分別為54.5%、75%，對(duì)照組比率分別為35.7%、54.8%，研究組有動(dòng)脈狹窄、不穩(wěn)定斑塊的比率明顯高于對(duì)照組，P0.05，有統(tǒng)計(jì)學(xué)意義。4、臨床表現(xiàn)：SCI無確切的神經(jīng)系統(tǒng)定位癥狀與體征，主要表現(xiàn)為一些非特異性癥狀及體征。本研究統(tǒng)計(jì)如下：頭痛、頭暈、頭昏、主觀感覺異常；注意力不集中、記憶力減退及計(jì)算力下降；抑郁、焦慮等。多數(shù)患者具有以上兩種或兩種以上癥狀組合。5、SCI共發(fā)現(xiàn)非責(zé)任病灶382個(gè)，其中，基底節(jié)區(qū)127個(gè)，放射冠區(qū)96個(gè)，內(nèi)囊65個(gè)，丘腦32個(gè)，腦干23個(gè)，小腦7個(gè)，腦葉32個(gè)。病灶直徑在≤1.5cm的327個(gè)（85.6%），1.5cm病灶≤3.0cm的病灶47個(gè)（12.3%）,3.0cm病灶≤5.0cm的病灶8個(gè)（2.1%）。 結(jié)論首發(fā)急性腦梗死中無癥狀性腦梗死患病率高；女性及年齡≥60歲人群更容易患無癥狀性腦梗死；具有動(dòng)脈狹窄或不穩(wěn)定斑塊的患者容易患無癥狀性腦梗死；無癥狀性腦梗死主要表現(xiàn)為一些非特異性癥狀，無確切的神經(jīng)系統(tǒng)定位癥狀與體征；無癥狀性腦梗死病灶以腔隙性梗死為主，病灶分布以基底節(jié)、放射冠及內(nèi)囊多見。
[Abstract]:Objective to analyze the prevalence, risk factors, clinical manifestations, MRI features and clinical significance of asymptomatic cerebral infarction in patients with acute cerebral infarction. Methods from March 2011 to December 2012, 130 patients with acute cerebral infarction who were hospitalized in the second Clinical Hospital of Jilin University were collected. All the patients denied that they had suffered from cerebrovascular disease, head injury, space occupying, etc. All of them had the first symptom and sign of nervous system deficiency, and all of them were in accordance with the criteria for the diagnosis of asymptomatic cerebral infarction established by the fourth National Conference on Cerebrovascular Disease. According to head MRI, 88 cases were divided into study group (including 50 males and 38 females), and 42 cases (32 males and 10 females) in the control group (only responsible for acute cerebral infarction) in which there were both responsible and non-responsible lesions of acute cerebral infarction (ACI) in the study group (50 males and 38 females). The patient's history, body examination, blood glucose, blood lipid, electrocardiogram, head MRI, head and neck vascular ultrasound, etc. To determine the risk factors of cerebrovascular disease, including age, smoking, drinking history, blood lipid, blood pressure, blood sugar, atrial fibrillation, atherosclerotic plaque and arterial stenosis. The risk factors and clinical significance of the two groups were compared, and the clinical manifestations and MRI features of the head in the study group were summarized and analyzed. Results 1. The prevalence rate of sci was 67.7% in the first acute cerebral infarction patients. Sex: in the first acute cerebral infarction patients, the prevalence rate of SCI was 61.0 in males and 79.2 in females. The prevalence rate of SCI in females was higher than that in males (P0.05). Age: the study group had 49.3% of the patients with SCI, 89.8 with 鈮

本文編號(hào)：2249939