大动脉炎致脑梗死临床分析

Clinical analysis of cerebral infarction caused by Takayasu＇ s Arteritis

目的 探讨大动脉炎致脑梗死患者的临床特点和诊治情况.方法 回顾性分析2002年1月～2010年4月在我院神经内科住院的12例大动脉炎所致脑梗死患者的临床资料.结果 12例患者均有颈总动脉或锁骨下动脉或椎动脉及其分支的狭窄或闭塞,查弓上颅外段动脉磁共振血管造影、CT血管成像均有阳性发现.均为青中年患者,以女性为主,经Essen卒中风险评分量表评分均为0～2分,属于脑卒中低危患者.经激素或加用小剂量免疫抑制剂治疗均有效.结论 大动脉炎致脑梗死容易漏诊.对年轻的脑卒中低危患者,特别是女性,需要明确有无大动脉炎,而弓上血管磁共振血管造影、CT血管成像有较高的诊断价值.明确诊断后应早期给予激素或加用小剂量免疫抑制剂治疗.

Objective To explore the clinical features and treatment of the patients with cerebral infarction caused by Takayasu＇ s Arteritis （TA）. Methods Hospitalized in neurology from January 2002 to April 2010 ,datas of the 12 cases with cerebral infarction caused by Takayasu＇ s Arteritis was analysed retrospectively. Results From the 12 eases, all patients have stenosis or occlusion of cephalic artery or arteriae subclavia or vertebral artery or there branches. Supra-arch extracranial artery MRA or CTA were all positive. All were the patients with low-risk of stroke, young and middle-aged, mostly female, Essen Stroke Risk Score graded 0 to 2 points. Corticosteroid or added with small dose immunosuppressant, were effective. Conclusions Cerebral infarction caused by TA was to be misseddiagnosis. For young patients with low-risk of stroke, especially female,it is necessary to clarify a diagnosis of TA. Supra-arch extraeranial artery MRA or CTA has superior diagnostic value. Cortieosteroid or added with small dose immunosuppressant should be treated as early as possible.