进展性脑卒中15例临床及脑血流特征

Clinical characteristics and cerebral blood flow in 15 patients of progressive stroke

目的通过研究伴有血管狭窄的进展性脑卒中患者的临床资料及脑血流情况，总结其临床特征，并探讨病情进展与脑血流量变化间的关系。方法对15例有血管狭窄，符合前循环梗死的进展性啮卒中患者的临床资料进行分析总结，并应用Xe-CT检测患者病情进展过程中脑组织血流情况。结果本组患者多以一侧肢体瘫痪起病（13例），病情进展较快，上肢瘫痪重于下肢（11例），梗死病灶多在分水岭区（10例）。15例患者中有11例在病情进展过程中行脑血流量检测，示病灶周围存在较大面积的低灌注区（10ml·100g^-1·min^-1〈脑血流量〈20ml·100g^-1·min^-1）。结论伴有血管狭窄的进展性脑卒中患者有特征性的临床表现，狭窄血管所致的低灌注可能是导致病情进展的重要原因之一。

Objective To observe the clinical characteristics of progressive stroke （PS） patients with vascular stenosis and the relationship between PS and cerebral blood flow （ CBF）. Methods Fifteen patients of PS with anterior circulation vascular stenosis were chosen, their clinical documents and CBF were analyzed with Xenon-CT when they were in progression. Results These patients mostly presented hemiparalysis and language dysfunction at the beginning （ 13/15 ） before the disease developed rapidly into a serious state. The infarction usually happens in the periventricular area （ 10/15 ）. Upper limbs paralyzed more severely than low limbs（11/15）. Cerebral hypoperfusion areas around the infarction in 11 patients （10 ml·100 g^-1·min^-1 〈CBF〈20 ml·100 g^-1·min^-1） were found. Conclusions Patients of PS with vascular stenosis present typically clinical characteristics. Low CBF caused by cerebral artery stenosis may be one of the most important factors leading to PS.