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152例大脑后动脉供血区脑梗死的病因及梗死模式的研究
A Research about Etiologies and Pattern of Posterior Cerebral Artery Infarction in 152 Patients

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DOI:
作者:
张晶晶 刘丽 高晓梅
Zhang JingJing Liu Li Gao Xiaomei
作者单位:
赤峰市医院
chifeng municipal hospital
关键词:
大脑后动脉梗死 病因 梗死模式 梗死机制
Posterior Cerebral Artery territory Infarction Etiology infarction pattern infarction mechanism
摘要:
目的：调查PCA梗死的病因及梗死模式构成。方法：回顾性分析147名PCA供血区梗死患者，分为单纯PCA梗死组和多发梗死组，比较两组间脑血管病危险因素、病因、梗死模式的差异性。结果：全部患者平均年龄59.5±8.9岁，单纯PCA梗死组105人（71.4%），多发梗死组42人（28.6%）。多发梗死组患者中既往卒中和心脏病史比例明显高于单纯梗死组（分别为31.0% vs 11.4%,p=0.004；42.9% vs 21.0%，p=0.007）；最常见致病原因为大动脉粥样硬化 (44.2%)。多发梗死组CE比例明显高于单纯PCA梗死组（28.6% vs 13.3%）,而单纯PCA梗死组SVO的比例高于多发梗死组（35.2% vs 0%），（p＜0.001)。丘脑梗死最多见（63.9%），其次为枕叶（32.7%）。单纯PCA梗死组深穿支梗死的比例明显高于多发梗死组（56.2% vs 21.4%），而多发梗死组皮质梗死的比例高于单纯PCA梗死组(50.0% vs 18.1%)，（p＜0.001）。结论：国人PCA供血区梗死最常见病因可能是大动脉粥样硬化性，最常见的梗死部位是丘脑，后循环供血区单纯PCA梗死与多发梗死患者间病因及梗死模式构成不同。
To investigate etiologies and patterns of posterior cerebral artery (PCA) territory infarction. Method: A retrospective research was carried out among 147patients with PCA territory infarction ,whom were divided into pure PCA infarction group（PPI）and multiple infarction(MI) according to wether there were multiple infarctions in different cerebra artery territories of posterior cerebral circulation, comparing difference of risk factors and etiologies and patterns between two groups. Results: The average age was 49.5±8.9 years, there were a higher proportion of previous stroke history and heart disease in MI than PPI (Respectively, 31.0% vs 11.4%,p=0.004；42.9% vs 21.0%，p=0.007);The most frequent etiology was large artery atherosclerosis (42.2%). There was a higher incidence of cardiogenic embolism in MI than PPI (28.6% vs 13.3%),while a lower incidence of small vascular occlusion (0% vs 35.2%), (p＜0.001);The most common location of cerebral infarction was thalamus infarction(63.9%), followed by occipital lobe infarction(32.7%); There was a higher prevalence of superficial infarct in MI than PPI (50.0% vs 18.1%),while a lower incidence of deep infarction(56.2% vs 21.4%), (p＜0.001).conclusion: Large artery atherosclerosis is the most common etiology of PCA territory infarction in Chinese population, the thalamus is the most common infarction area. There are variant constituent ratio of etiology and infarct pattern between pure PCA territory infarction and multiple infarction in posterior cerebral circulation.

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