不同类型急性缺血性脑血管病患者脑微出血的对比研究-东南大学学报医学版

不同类型急性缺血性脑血管病患者脑微出血的对比研究

作者：丁建

单位：沧州市人民医院, 河北沧州 061000

分类号：R743.34

出版年·卷·期（页码）：2015·34·第一期（96-99）

摘要：

目的:探讨不同类型急性缺血性脑血管病患者脑微出血(CMBs)的发生率及严重程度。方法:收集急性缺血性脑血管病患者852例,其中短暂性脑缺血发作(TIA)46例,急性脑梗死806例[根据TOAST分型标准分为动脉粥样硬化性血栓形成(A组)484例,心源性脑栓塞(B组)92例,小动脉性脑梗死(C组)166例,不明原因脑梗死(D组)64例)]。另选择同期健康体检者102例作为对照。比较各组CMBs发生率、严重程度及比较初发、复发患者的发生率。结果:与对照组比较,A组、C组的年龄及高血压病史、糖尿病史、吸烟史、脑白质病患者的比例明显增高(P<0.05);B组糖尿病史患者的比例明显高于对照组(P<0.05);TIA组的年龄明显高于对照组(P<0.05)。急性脑梗死患者4个分组CMBs发生率明显高于对照组(P<0.05);A组CMBs分布在Ⅱ、Ⅲ、Ⅳ级的比例接近,B组集中分布于Ⅱ级,C组Ⅳ级多见,D组及TIA组以Ⅱ级多见。初发急性梗死患者的CMBs发生率明显低于复发患者(P<0.05)。A组、C组初发急性梗死患者CMBs发生率明显低于复发患者(P<0.05)。结论:不同类型的急性脑缺血性脑血管病患者的CMBs发生率及严重程度差异较大,另外在初发、复发型脑梗死患者中的CMBs发生率也不尽相同,这可能与CMBs不同的影响因素差别大有关。

Objective: To investigate the incidence and severity of cerebral microbleeds (CMBs)in patients with different types of acute ischemic cerebrovascular disease. Methods: 852 patients with acute ischemic cerebrovascular disease were selected, where there were 46 patients with transient ischemic attack (TIA) and 806 patients with acute cerebral infarction.According to TOAST classification standards, the patients with acute cerebral infarction were divided into atherosclerotic thrombosis (group A) where there were 484 cases, cardiogenic cerebral embolism (group B) where there were 92 cases, arterial cerebral infarction (group C) where there were 166 cases, unexplained cerebral infarction (group D) where there were 64 cases. Another 102 healthy people were selected as control group. The CMBs incidence, severity among all groups, or the incidence of patients with acute cerebral infarction between primary patients and recurrent patients were compared. Results: The patients' age, proportion of patient with hypertension history, diabetes history, smoking history, brain white matter disease of group A, group C were significantly higher than those of control group (P<0.05). The proportion of patient with diabetes history of group B was significantly higher than that of control group (P<0.05). The patients' age of TIA group was significantly higher than that of control group (P<0.05). The CMBs incidence in four group of patients with acute cerebral infarction were higher than that in control group (P<0.05). The CMBs distribution proportion in group A was close among grade Ⅱ, Ⅲ, Ⅳ. Group B was concentrated in grade Ⅱ, while group C in grade Ⅳ, group D and TIA group in grade Ⅱ. The CMBs incidence of patients with primary acute infarction was significantly lower than that of recurrent patients (P<0.05). The CMBs incidence of patients with primary acute infarction of group A or group C was significantly lower than that of recurrent patients (P<0.05). Conclusion: The CMBs incidence and severity of different types of patients with acute cerebral ischemic cerebrovascular disease have great differences, in addition to the incidence of CMBs in primary, recurrent patients with cerebral infarction is different, which may be related to different risk factors whose influence has large diffences.

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