【摘要】：目的探討責任性顱內動脈粥樣硬化性狹窄(Intracranial atherosclerotic stenosis,ICAS)致首發(fā)缺血性腦卒中(Ischemic stroke,IS)解剖模式與發(fā)病機制的關系。方法回顧性分析261例責任性ICAS致首發(fā)IS患者的臨床資料。根據(jù)彌散加權成像(DWI)的影像學表現(xiàn)分為單發(fā)病灶(皮質-皮質下梗死、皮質梗死、皮質下梗死),彌散病灶,多發(fā)病灶(單側前循環(huán)或后循環(huán)多發(fā)梗死);卒中機制分為動脈到動脈栓塞、原位血栓形成、穿支動脈閉塞、低灌注、多發(fā)機制等。結果單發(fā)皮質下梗死是責任性ICAS致首發(fā)IS最常見的卒中模式(41.38%,108/261);責任性ICAS致IS主要發(fā)病機制為穿支動脈閉塞(41.38%,108/261);責任性ICAS致IS的解剖模式與發(fā)病機制顯著相關(r=0.384,P=0.001),穿支動脈閉塞與皮質下梗死相關(r=0.805,P=0.001),彌散梗死、單側前循環(huán)多發(fā)梗死、后循環(huán)多發(fā)性梗死,分別與動脈到動脈栓塞(r=0.853,P=0.001;r=0.860,P=0.001;r=0.281,P=0.001)、及多發(fā)機制(r=0.792,P=0.001;r=0.883,P=0.001;r=0.213,P=0.001)相關。結論卒中解剖模式有助于明確責任性ICAS致缺血性腦卒中的發(fā)病機制,有利于指導其臨床診治及預防措施的擬定。
[Abstract]:Objective to investigate the relationship between anatomical pattern and pathogenesis of primary ischemic stroke (Ischemic stroke,IS) caused by responsible intracranial atherosclerotic stenosis (Intracranial atherosclerotic stenosis,ICAS). Methods the clinical data of 261patients with IS caused by responsible ICAS were analyzed retrospectively. According to the imaging findings of diffusion-weighted imaging (DWI), they were divided into single focus (subcortical infarction, subcortical infarction), diffusion focus and multiple focus (unilateral anterior circulation or posterior circulation multiple infarction). The mechanism of stroke can be divided into artery to artery embolism, thrombosis in situ, occlusion of perforator artery, hypoperfusion, multiple mechanism and so on. Results single subcortical infarction was the most common stroke pattern of IS caused by responsible ICAS (41.38%, 108%), and the main pathogenesis of IS caused by responsible ICAS was perforating artery occlusion (41.38%, 108%). The anatomical pattern of IS induced by responsible ICAS was significantly correlated with the pathogenesis (r 鈮，

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