青年糖尿病并发脑梗死的临床及脑血管造影研究

Clinical and cerebral angiographic study in young adults with diabetic ischemic stroke

目的总结青年糖尿病患者的临床及神经影像学特点。方法回顾分析23例青年糖尿病患者的主要临床表现及辅助检查结果,5例患者行全脑血管造影(DSA)检查。结果基底节区梗死14例,脑干梗死4例,脑叶梗死4例,侧脑室旁梗死1例。血管造影显示:80%的患者为多支颅内血管病变,前循环合并后循环。1例还同时合并右冠状动脉第一屈曲部完全闭塞。颈内动脉及大脑中动脉主干受累最常见,1例患者右侧颈内动脉次全闭塞。结论动脉粥样硬化是青年糖尿病并发脑梗死的重要致病原因,颅内大、中、小血管可以同时受累,侧支循环代偿是患者预后良好的重要原因。

Objective To study the clinical and neuroimaging features in young adults with diabetic ischemic stroke. Methods We retrospectively analyzed the clinical data and the features of accessory examination of 23 cases. 5 patients underwent high selective cerebral angiographies for the observation of aorta, carotid arteries, vertebral arteries and all intracranial arteries Results The brain MRI found basal ganglia infarctions in 14 cases, brain stem infarctions in 4 cases, lobar infarctions in 4 cases and para-lateralventricular infarction in 1 case. Angiography showed occlusive findings of cerebral arteries in all patients. 4 eases of them were found two or more cerebrolvascular lesions, involved anterior and posterior circulation. The internal carotid arteries and middle cerebral arteries are most frequently involved and the internal carotid artery is almost completely occlusion in one case. Conclusions Arteriosclerosis is one of the important factors in the process of pathogenesis. The young patients with diabetic stroke have better outcome that is related to the better collateral circulation.