老年后循环脑梗死患者89例临床观察

Clinical Investigation of 89 Old Patients with Cerebral Infarction in Posterior Circulation

目的研究老年患者后循环脑梗死的病因、危险因素、临床表现及责任病变血管的特点。方法收集2004-01-2004-12作者医院神经内科住院的89例老年后循环脑梗死患者的临床资料,分析其病因及危险因素,按不同责任病变血管分类并比较不同类型患者的临床特点。结果主要病因为动脉粥样硬化共82例(92.1%)。危险因素包括吸烟43例、饮酒31例、高血压67例、糖尿病37例、高同型半胱氨酸血症20例、脂代谢异常69例、冠心病38例、既往脑卒中史27例、出现梗死前短暂性脑缺血发作(TIA)37例。临床表现以眩晕最常见共74例(83.1%),其次为构音障碍47例、感觉障碍35例及运动障碍23例。按不同责任病变血管分类,以颅内段椎动脉病变出现眩晕所占比例最高(92.9%)。梗死前出现TIA可能与预后良好相关(P<0.05)。结论动脉粥样硬化是老年后循环脑梗死的最常见病因。眩晕、构音障碍、感觉运动障碍是其常见临床表现。梗死前TIA可能提示预后良好。

Objective To study the features of etiopathogenisis, risk factors, clinical manifestations and vascular lesions of the old patients with posterior circulation ischemia（PCI）. Methods 89 old patients with cerebral infarction in posterior circulation who were admitted in 2004-01-2004-12 were selected. The etiopathogenisis, risk factors, clinical manifestation were studied, and the vessel lesions were evaluated. Results It was found that artherosclerosis was the main cause in 92.1 % of these old patients with cerebral infarction in posterior circulation. Smoking, hypertension, hyperlipemia, diabetes mellitus were common risk factors. The clinical manifestations such as vertigo （83.1 %）, dysarthria （47）, sensory disability （35）, hemiplegia （23） were more common. Vertigo of the patients with intracranial arteria vertebralis （ICVA） was most frequently （92. 9%）, otherwise the patients with transient ischemia attach （TIA） before cerebral infarction had good prognosis probably （P 〈 0.05）. Conclusions Artherosclerosis was the main etiopathogenisis, and vertigo, dysarthria, sensory disability, hemiparalysis were the common clinical symptoms and signs in PCI. TIA before infarction might probably lead to good prognosis.