本文選題：非大動(dòng)脈粥樣硬化型腦梗死 + TOAST分型��； 參考：《寧夏醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的分析非大動(dòng)脈粥樣硬化型腦梗死的病因和危險(xiǎn)因素、神經(jīng)功能缺損情況、影像學(xué)檢查、治療及預(yù)后。方法連續(xù)收集非大動(dòng)脈粥樣硬化型腦梗死患者155例,按照TOAST分型標(biāo)準(zhǔn)進(jìn)行病因分型并分析其臨床特點(diǎn)。結(jié)果本研究共納入155例患者(男性99例,女性56例)。本組患者TOAST分型的結(jié)果是:小動(dòng)脈閉塞型97例(62.6%),心源性栓塞型26例(16.8%),不明原因型20例(12.9%),其他明確病因型12例(7.7%)。本組患者的危險(xiǎn)因素為:高血壓病(96例,61.9%)、高同型半胱氨酸血癥(65例,41.9%)、吸煙(56例,36.1%)、糖尿病(51例,32.9%)、高脂血癥(49例,31.6%)。高血壓病(74.2%,?2=18.106,P0.01)和高脂血癥(40.2%,?2=10.818,P0.05)的發(fā)生率在小動(dòng)脈閉塞型中顯著增高。小動(dòng)脈閉塞型入院時(shí)神經(jīng)功能缺損評分最低(2.93±2.40),心源性栓塞型入院時(shí)神經(jīng)功能缺損評分最高(7.58±4.74)(?2=21.797,P0.05)。心源性栓塞型ESRS平均評分分別大于其他明確病因型和不明原因型(F=4.134,P0.05,P0.05),小動(dòng)脈閉塞型ESRS平均評分分別大于其他明確病因型和不明原因型(F=4.134,P0.05,P0.05)。結(jié)論在非大動(dòng)脈粥樣硬化型腦梗死中小動(dòng)脈閉塞型所占比例最高,其他明確病因型所占比例最低。心源性栓塞型腦梗死好發(fā)于中年、老年患者,而其他明確病因型好發(fā)于青年患者。高血壓病或高脂血癥在小動(dòng)脈閉塞型腦梗死中更顯著。小動(dòng)脈閉塞型腦梗死患者入院時(shí)神經(jīng)功能缺損最輕,心源性栓塞型腦梗死患者入院時(shí)神經(jīng)功能缺損最重。非大動(dòng)脈粥樣硬化型腦梗死病因復(fù)雜多樣,各亞型的臨床特點(diǎn)存在較大差異,臨床上需要根據(jù)不同病因予以個(gè)體化醫(yī)療支持及評估預(yù)后。
[Abstract]:Objective to analyze the etiology and risk factors, neurological deficit, imaging examination, treatment and prognosis of non-arteriosclerotic cerebral infarction. Methods 155 patients with non-arteriosclerotic cerebral infarction were collected and analyzed according to TOAST classification criteria. Results 155 patients (99 males and 56 females) were included in this study. The results of TOAST classification were as follows: small artery occlusion in 97 cases, cardiogenic embolism type in 26 cases, cardiac embolism type in 26 cases, unknown cause type in 20 cases, and other definite etiological type in 12 cases. The risk factors were as follows: 96 cases of hypertension, 65 cases of hyperhomocysteinemia and 41.9%, 56 cases of smoking, 51 cases of diabetes mellitus, 51 cases of diabetes mellitus, 49 cases of hyperlipidemia and 49 cases of hyperlipidemia. The incidence of hypertension (74.2) and hyperlipidemia (40.22) and hyperlipidemia (40.22) were significantly higher in the arteriole occlusion type. The neurological deficit score of arteriole occlusion type was the lowest (2.93 鹵2.40) on admission, and that of cardiac embolism type was the highest (7.58 鹵4.74) on admission (P 0.05). The average score of ESRS of cardiac embolism type was higher than that of other definite etiology type and unknown cause type, respectively. The mean score of small artery occlusion type ESRS was higher than that of other definite etiological type and unknown cause type (P 0.05 P 0.05) respectively, and the mean score of small artery occlusion type was higher than that of other definite etiological type and unknown cause type. Conclusion the proportion of arteriole occlusion is the highest in non-arteriosclerosis cerebral infarction and the lowest in other definite etiological types. Cardiogenic embolism cerebral infarction is more common in middle-aged and elderly patients, while other definite etiological types are more common in young patients. Hypertension or hyperlipidemia is more significant in arterio-occlusive cerebral infarction. The patients with arteriolar occlusive cerebral infarction had the lightest neurological deficit at admission, and the patients with cardiogenic embolism cerebral infarction had the most severe neurological impairment at admission. The etiology of non-arteriosclerotic cerebral infarction is complex and diverse, and the clinical characteristics of each subtype are quite different. Therefore, individualized medical support should be given according to the different causes and the prognosis should be evaluated.
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R743.3

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