【摘要】：目的：1)研究單純枕葉梗死危險(xiǎn)因素與其他部位腦梗死的差異性；2)研究單純枕葉梗死的病因；3)研究單純枕葉梗死的臨床表現(xiàn)；4)研究枕葉梗死的預(yù)后。 方法：收集2003年1月至2013年12月于我院（大連醫(yī)科大學(xué)附屬第二醫(yī)院）神經(jīng)內(nèi)科住院的152例患者。其中41例為單純枕葉梗死，71例為枕葉合并其他部位梗死和40例非枕葉后循環(huán)梗死患者。住院時(shí)離發(fā)病時(shí)間最早為2小時(shí)，最晚1個(gè)月，診斷標(biāo)準(zhǔn)按照第五屆全國(guó)腦血管病會(huì)議制定的標(biāo)準(zhǔn)。入院后均行顱腦核磁共振檢查及血管評(píng)估檢查，記錄入選對(duì)象高血壓病史、吸煙、糖尿病病史、飲酒、冠心病、房顫、既往腦梗死病史等腦梗死的相關(guān)危險(xiǎn)因素以及臨床表現(xiàn)。所有病例依據(jù)梗死部位分為3組，即A組為單純枕葉梗死組、B組為枕葉合并其他部位梗死組、C組為后循環(huán)非枕葉梗死組。A組中，男31例,女10例，男女比例3.10:1，年齡44-91歲，平均年齡67.3211.856歲；B組中，男42例，女29例，男女比例1.45:1，年齡40-92歲，平均年齡68.1711.426歲；C組中,男23例,女17例，男女比例1.35:1，年齡50-83歲，平均年齡68.159.736歲。采用單因素方差分析和χ2檢驗(yàn)比較三組的危險(xiǎn)因素；采用χ2檢驗(yàn)比較三組病因構(gòu)成比之間差異；預(yù)后相關(guān)分析采用Logistic回歸。設(shè)定檢驗(yàn)標(biāo)準(zhǔn)為0.05， P＜0.05時(shí)，差異有統(tǒng)計(jì)學(xué)意義。 結(jié)果：危險(xiǎn)因素:三組所有的危險(xiǎn)因素比較，均為P〉0.05，差異無(wú)統(tǒng)計(jì)學(xué)意義，，A組、B組及C組的危險(xiǎn)因素?zé)o差異性。高血壓病在危險(xiǎn)因素中所占的比例最高，其次是吸煙，三組中男性比女性腦梗死的發(fā)病率更高。病因分析中，發(fā)現(xiàn)A組和B組,B組和C組之間病因構(gòu)成比存在差異性,A組和C組之間病因構(gòu)成比無(wú)差異性；A組和C組病因最多見(jiàn)的是大動(dòng)脈粥樣硬化,其次是穿支動(dòng)脈疾�。粏渭冋砣~梗死中，大動(dòng)脈狹窄≥50%的最常見(jiàn)的是椎動(dòng)脈，其次是頸內(nèi)動(dòng)脈，第三是大腦后動(dòng)脈。臨床表現(xiàn)：視覺(jué)障礙、頭痛、肢體癱瘓、感覺(jué)障礙在單純枕葉梗死中有較高的發(fā)生率,單純枕葉梗死還可表現(xiàn)出眩暈和（或）嘔吐、言語(yǔ)不清、失語(yǔ)、TIA、小便失禁、無(wú)癥狀、共濟(jì)失調(diào)，但無(wú)特異性；視覺(jué)障礙中以視物模糊及視力減退最常見(jiàn),視覺(jué)障礙和預(yù)后有相關(guān)性，相關(guān)系數(shù)為-1.167，呈負(fù)相關(guān)，存在視覺(jué)障礙的枕葉梗死預(yù)后不良。預(yù)后：按組別為分類標(biāo)準(zhǔn)，對(duì)三組的預(yù)后進(jìn)行檢驗(yàn)，發(fā)現(xiàn)2=6.044，P=0.1960.05，三組的預(yù)后無(wú)明顯差異性；但以是否發(fā)生視覺(jué)障礙為分類標(biāo)準(zhǔn)，發(fā)現(xiàn)2=6.043，P=0.0490.05，差異有統(tǒng)計(jì)學(xué)意義，存在視覺(jué)障礙的枕葉梗死預(yù)后不良。 結(jié)論：1.單純枕葉梗死的病因最常見(jiàn)的是大動(dòng)脈粥樣硬化，單純枕葉梗死中狹窄≥50%的大動(dòng)脈最多見(jiàn)的是椎動(dòng)脈，其次是頸內(nèi)動(dòng)脈，第三是大腦后動(dòng)脈； 2．視覺(jué)障礙及頭痛在單純枕葉梗死中具有較高的發(fā)生率,單純枕葉梗死還可以有眩暈和（或）嘔吐、言語(yǔ)不清、失語(yǔ)、TIA、小便失禁、無(wú)癥狀、共濟(jì)失調(diào)等表現(xiàn)。
[Abstract]:Objective: to study the difference between the risk factors of occipital infarction and other cerebral infarction (2) to study the etiology of occipital lobe infarction (3) to study the clinical manifestations of occipital lobe infarction 4) to study the prognosis of occipital infarction. Methods: from January 2003 to December 2013, 152 patients were hospitalized in Department of Neurology, Dalian Medical University (second affiliated Hospital of Dalian Medical University). Among them, 41 cases were simple occipital lobe infarction, 71 cases were occipital lobe with other infarction and 40 cases were non-occipital posterior circulation infarction. The first two hours from the onset of the disease, the latest one month, the diagnostic criteria according to the Fifth National Conference on Cerebrovascular Disease standards. After admission, MRI and vascular assessment were performed to record the risk factors and clinical manifestations of cerebral infarction, such as history of hypertension, smoking, diabetes mellitus, alcohol consumption, coronary heart disease, atrial fibrillation and previous history of cerebral infarction. All the patients were divided into three groups according to the infarct location. Group A was simple occipital infarction group B group was occipital lobe infarction group C group was posterior circulation non-occipital lobe infarction group, male 31 cases, female 10 cases, male to female ratio 3.10: 1, age 44 to 91 years old. The average age of group B was 67.3211.856 years old. There were 42 males and 29 females, the ratio of male to female was 1.45: 1, the age was 40-92 years old, the average age was 68.1711.426 years old, there were 23 males and 17 females, the ratio of male to female was 1.35: 1, the age was 50-83 years old, the average age was 68.159.736 years old. Univariate ANOVA and 蠂 2 test were used to compare the risk factors of the three groups, 蠂 2 test was used to compare the difference of the etiological composition ratio among the three groups, and Logistic regression was used to analyze the prognostic correlation. The test standard was 0.05, P < 0.05, the difference was statistically significant. Results: all the risk factors in the three groups were compared with each other (P > 0.05). There was no significant difference in the risk factors between group A and group C. Hypertension accounted for the highest proportion of risk factors, followed by smoking. The incidence of cerebral infarction in males was higher than that in females. In etiological analysis, it was found that there was a difference in etiological composition ratio between group A and group B and group C. The most common etiology of group A and group C was atherosclerosis, followed by perforating artery disease. In simple occipital infarction, the main artery stenosis 鈮

本文編號(hào)：2226817