38例纹状体内囊梗塞的临床分析

CLINICAL ANALYSIS OF THIRTY-EIGHT PATIENTS WITH STRIATOCAPSULAR INFARCTION

目的探讨皮层型纹状体内囊梗塞(CSCI)和非皮层型SCI的临床、影像学差异及病理生理机制。方法回顾性分析了38例SCI患者,其卒中危险因素,临床特点,和MRI、MRA影像学资料,比较CSCI和NCSCI两者差异。结果38例SCI中23例CSCI,15例NCSCI,两组间年龄、性别比无显著差异,但是NCSCI组糖尿病更多见(P<0.05)。CSCI组发病时的神经功能缺损较NCSCI组更显著(P<0.01,采用NIHSS评分和巴塞尔指数);而起病时与入院第七天的评分差值比较,两组间没有统计学差异(P>0.05),即总体的改善两组间没有不同。两组间MRI上的病灶形态没有显著差异(P>0.05),CSCI组病人MRA上同侧大脑中动脉(MCA)狭窄更多见(P<0.05)。结论CSCI组发病时的神经功能缺损较NCSCI组更显著,这组病人MRA上同侧大脑中动脉狭窄也更多见,MRA对SCI患者的预后评估应更有意义。

Objective To study the differences of clinical characters, neuroimagings and pathologic mechanisms between CSCI and NCSCI. Methods We reviewed 38 SCI patients, analyzed their risk factors, clinical characters and their neuroimaging data, compared differences between CSCI group and NCSCI group. Results There were no differences in their ages, sexes between CSCI group (23 cases) and NCSCI group (15 cases), but there were more diabetic patients in NCSCI group. The initial nervous functional deficits in CSCI group were more prominent than that of NCSCI group(P < 0.01). No differences were found when compared the D-value of initial score with seventh day score. No differences of morphorlogic changes by MRI were found( P > 0.05). But much more homolateral MCA stenosis were found in CSCI group than that of NCSCI group( P < 0.01). Conclusions There were more initial nervous functional deficits and homolateral MCA stenosis in CSCI group, the MRA data are more predictive in evaluating prognosis of SCI patients.