心源性脑栓塞72例临床分析

Clinical analysis of 72 patients with cardiogenic cerebral embolism.

目的探讨心源性脑栓塞(CCE)的病因、临床表现及预后。方法分析2007年4月至12月温州医学院附属第一医院收治的发病1周以内CCE患者的临床资料及随访3个月的预后情况。结果共纳入CCE患者72例,伴心房颤动者占68.06%(49/72),发病后3个月的随访发现,病死率达20.8%(15/72),生活依赖者(BI<60)占34.72%(25/72)。结论心房颤动为CCE最常见的病因,颈内动脉系统较椎-基底动脉系统更易形成栓塞,前者的神经功能损伤显著重于后者,且预后更差。

Objective To study the etiology, clinical features and prognosis of cardiogenic cerebral embolism. Methods Cardiogenic cerebral embolism patients in the ward of Department of Cerebral vessels from April 2007 to December 2007 were registered prospectively, and then the clinical data of the patients after 3 months follow-up were analyzed. Results 72 patients were included ,49 patients had atrial fibrillation. At the end of the 3 month-follow-up, 15 patients were dead, the total mortality was 20. 8%. 25 patients must depend on others to live on. Conclusion Atrial fibrillation was the most common etiology of cardiogenic cerebral embolism. Internal carotid artery systerm was easier to form embolism than verte- brobasilar systerm. Compared with vertebrobasilar systerm,internal carotid artery systerm was much worse on nerve function impairment and prognosis. Positive measures must be taken to prevent and treat primary cardiopathy, and reduce the rate of cardiogenic cerebral embolism.