不同类型腔隙性脑梗死发病机制的探讨

被引：20

作者：

陈兰兰

徐耀

马灿灿

于海龙

李晓波

徐俊

机构：

[1] 江苏省苏北人民医院神经内科

来源：

中华老年心脑血管病杂志 | 2016年 / 18卷 / 09期

关键词：

脑梗死; 动脉粥样硬化; 心房颤动; 颈动脉狭窄; 磁共振成像; 危险因素;

D O I：

暂无

中图分类号：

R743.3 [急性脑血管疾病（中风）];

学科分类号：

1002 ;

摘要：

目的通过比较不同类型腔隙性脑梗死（lacunar infarction,LI）与非LI的危险因素,推测其发病机制。方法回顾性分析2008年8月1日2014年12月13日入住我院的急性颈内动脉系统脑梗死患者的临床资料,根据临床表现及影像学结果筛选出符合入选标准的患者LI 148例和非LI 148例。根据头颅MRI弥散加权成像上病灶数目及位置分为单发LI 113例,多发LI 35例;单发非LI 97例,多发非LI 51例。采用logistic回归分析IL的危险因素。结果单发LI的心房颤动及同侧颈动脉狭窄≥50%的发生率较多发LI（0.88%vs 11.43%,P=0.013;1.77%vs 17.14%,P=0.002）、单发非LI（0.88%vs 11.34%,P=0.001;1.77%vs 16.49%,P=0.000）、多发非LI（0.88%vs 9.80%,P=0.018;1.77%vs 17.65%,P=0.000）明显低。与单发LI比较,心房颤动及同侧颈动脉狭窄≥50%为多发LI（OR=26.353,95%CI:2.778～250.007,P=0.011;OR=11.483,95%CI:2.202～59.891,P=0.011）、单发非IL及多发非IL的独立危险因素。多发LI与单发非IL和多发非LI心房颤动及同侧动脉狭窄≥50%等危险因素无差异（P>0.05）。结论单发LI与多发LI具有不同的发病机制,推测动脉粥样硬化病变及心源性栓塞为多发性LI的重要发病机制,但参与单发LI发病过程的概率相对较少。

引用

页码：961 / 965

页数：5

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