本文選題：腦梗死 + 缺血性小卒中　； 參考：《山東醫(yī)藥》2017年27期

【摘要】：目的觀察516例缺血性小卒中患者的SSS-TOAST分型情況,并分析顱內(nèi)梗死灶的特點。方法缺血性小卒中患者516例,進行SSS-TOAST分型,觀察顱內(nèi)梗死灶情況。收集患者年齡、Essen卒中風(fēng)險分層量表(ESRS)評分、90 d改良Rankin量表(mRS)評分、頭顱核磁共振成像(MRI)+磁共振血管成像(MRA)+彌散加權(quán)成像(DWI)、頸部血管檢查等資料,并在不同SSS-TOAST分型間進行比較。結(jié)果 516例缺血性小卒中患者SSSTOAST分型為大動脈粥樣硬化型174例(33.72%)、心源性腦栓塞型39例(7.56%)、小動脈閉塞型229例(44.38%)、其他原因11例(2.13%)、原因不明63例(12.21%),主要類型為大動脈粥樣硬化型和小動脈閉塞型,其中大動脈粥樣硬化型患者大動脈狹窄、90 d mRS評分預(yù)后不良發(fā)生率高于小動脈閉塞型(P均0.05)。357例(69.19%)顱內(nèi)梗死灶為孤立性病灶,其中231例(64.71%)病灶在皮層下、深部白質(zhì)、基底節(jié)等常見位置;159例(30.81%)為多發(fā)病灶。282例(54.65%)患者顱內(nèi)梗死灶直徑(或之和)20 mm,234例(45.35%)直徑(或之和)≥20 mm。本組缺血性小卒中患者顱內(nèi)梗死灶多為孤立性病灶,多數(shù)病灶大小20 mm,孤立性病灶多位于常見位置(P均0.05)。結(jié)論缺血性小卒中患者SSS-TOAST分型多為大動脈粥樣硬化型和小動脈閉塞型,前者合并大動脈狹窄和預(yù)后不良比例更高;缺血性小卒中患者顱內(nèi)梗死灶多為常見位置的孤立性病灶,但部分患者顱內(nèi)梗死灶直徑≥20 mm,多發(fā)梗死灶者也占一定比例。
[Abstract]:Objective to observe the SSS-TOAST classification of 516 patients with ischemic stroke and analyze the characteristics of intracranial infarction. Methods SSS-TOAST classification was performed in 516 patients with ischemic stroke. The age of patients with stroke risk stratification scale (ESRS) was evaluated with the modified Rankin scale (90 d), the cranial magnetic resonance imaging (MRI), diffusion weighted imaging (DWI) and cervical vascular examination (DWI). The data were compared among different SSS-TOAST types. Results the SSSTOAST classification of 516 patients with ischemic stroke was as follows: large artery atherosclerotic type 174 cases, cardiogenic cerebral embolism type 39 cases, arteriole occlusion type 229 cases, small artery occlusion type 229 cases, other reasons 2.13%, and unknown reason 63 cases, the main type was large artery porridge. Like sclerosing and arteriolar occlusion, The incidence of poor prognosis in patients with arteriosclerotic arteriosclerosis was higher than that in patients with arteriole occlusion (P = 0.05, P = 0.050.357).) Intracranial infarctions were solitary lesions, of which 231 cases were located in the subcortical and deep white matter, among them, 64.71% of the lesions were located in the subcortical and deep white matter. The diameter (or sum) of the intracranial infarct was more than 20 mm. in 234 patients (or the sum of 20 mm), the diameter (or sum) of the infarct was more than 20 mm. in 159 cases of basal ganglia and 30.81% of the lesions, the diameter (or sum) of the infarct was more than 20 mm. in the patients with multiple lesions, the diameter of the infarct was more than 20 mm. Most of the cerebral infarcts in this group were solitary lesions, most of which were 20 mm in size, and most of the solitary lesions were located in common locations (P < 0.05). Conclusion the SSS-TOAST classification of ischemic stroke patients is mostly arteriosclerotic type and arterio-occlusive type, the former has a higher proportion of arterial stenosis and poor prognosis, and the intracranial infarction focus of ischemic stroke patients is mostly solitary lesions in common location. But in some patients, the diameter of cerebral infarction was 鈮，

本文編號：1841715