本文選題：腦梗死 + 靜止性腦梗死　； 參考：《青島大學(xué)》2013年碩士論文

【摘要】：目的：研究首次急性腦梗死合并靜止性腦梗死患者中,靜止性梗死病灶的影像學(xué)特點(diǎn)及相關(guān)危險(xiǎn)因素,探討其可能的病因和發(fā)病機(jī)制。 方法：選擇住院的首次急性腦梗死患者196例,通過顱腦MRI及相關(guān)血管檢查,分為首次腦梗死合并靜止性腦梗死組(SBI-P)88例和首次腦梗死無靜止性腦梗死組(SBI-N)108例,總結(jié)SBI病灶的影像學(xué)特點(diǎn),比較兩組的血管性危險(xiǎn)因素和腦白質(zhì)病變的比例,并比較在TOAST分型中,不同類型的腦梗死患者SBI的發(fā)生率。 結(jié)果：首次腦梗死合并SBI的患者共有88例,占所有首次腦梗死患者的44.9%,其中單個(gè)病灶者52例,占59.1%,多個(gè)病灶者36例,占40.9%；在單發(fā)病灶的患者中,有30例位于基底節(jié),占57.7%；在多發(fā)病灶的患者中,有28例累及到基底節(jié)區(qū)；在所有SBI患者中累及基底節(jié)的患者共58例,占72.2%。高齡、高血壓、顱腦MRI檢查發(fā)現(xiàn)腦白質(zhì)病變的患者中,SBI發(fā)生率較高(P0.05)；而其他的血管性危險(xiǎn)因素,包括糖尿病、高脂血癥、房顫、吸煙以及飲酒等與SBI的存在無明顯相關(guān)性(P0.05)。在196例首發(fā)腦梗死患者中,按照TOAST分型,LAD有105例,其中存在SBI者42例,占40.0%；SVD有60例,存在SBI者37例,占61.7%,在小血管病患者中更多的存在SBI(P0.05)。 結(jié)論：在癥狀性腦梗死患者中,SBI的發(fā)病率更高；高齡、高血壓和腦白質(zhì)病變與SBI的發(fā)生密切相關(guān),是其主要的危險(xiǎn)因素；在癥狀性腦梗死SVD型患者中,SBI的比例更高,提示SBI同小血管病有相似的病因和發(fā)病機(jī)制。
[Abstract]:Objective: to study the imaging features and related risk factors of the patients with acute cerebral infarction (ACI) complicated with static cerebral infarction (CI) for the first time, and to explore its possible etiology and pathogenesis. Methods: 196 inpatients with first acute cerebral infarction were divided into two groups: the first cerebral infarction with static cerebral infarction group (n = 88) and the first cerebral infarction group without static cerebral infarction group (n = 108) by craniocerebral MRI and related vascular examination. To summarize the imaging features of SBI lesions, compare the vascular risk factors and the proportion of white matter lesions between the two groups, and compare the incidence of SBI in patients with different types of cerebral infarction in toast classification. Results: there were 88 patients with first cerebral infarction complicated with SBI, accounting for 44.9 percent of all the patients with first cerebral infarction, 52 patients with a single lesion (59.1%), 36 patients with multiple lesions (40.9%), 30 patients with a single lesion in basal ganglia (57.7%). Among the patients with multiple lesions, 28 cases were involved in basal ganglia and 58 cases (72.2%) were involved in basal ganglia in all SBI patients. The incidence of SBI was higher in the elderly, hypertension, brain MRI patients with leukoencephalopathy, while other vascular risk factors, including diabetes mellitus, hyperlipidemia, atrial fibrillation, smoking and alcohol consumption, had no significant correlation with SBI. Among 196 patients with initial cerebral infarction, 105 cases were diagnosed as lad according to the toast classification, among which 42 cases had SBI, 60 cases had SVD and 37 cases had SBI, accounting for 61.7%. Conclusion: the incidence of SBI is higher in patients with symptomatic cerebral infarction, high age, hypertension and leukoencephalopathy are the main risk factors of SBI, and the proportion of SBI in SVD patients with symptomatic cerebral infarction is higher than that in patients with symptomatic cerebral infarction. It suggests that SBI has similar etiology and pathogenesis with small vascular disease.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R743.33

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