老年人脑干梗死与椎-基底动脉供血不足的病例回顾研究

A retrospective research on the elderly patients with brain stem infarction and vertebrobasilar insufficiency

目的探讨老年人脑干梗死与椎基底动脉供血不足(VB I)临床特点的异同。方法回顾分析14例老年脑干梗死患者以及95例老年VB I患者的症状、体征、化验结果、影像学等临床资料。结果脑干梗死组运动障碍、感觉障碍、饮水呛咳、构音障碍以及颅神经体征、浅感觉障碍、下肢病理征、肌力减退和共济失调的发生率(71.4%、57.1%、50.0%、71.4%、92.9%、35.7%、100.0%、78.6%、42.9%)显著高于VB I组(19.0%、16.4%、3.2%、3.2%、18.9%、14.7%、36.8%、20.0%、15.8%)。脑干梗死组高血压的患病率(85.7%)显著高于VB I组(50.5%)。脑干梗死组入院后血糖均值(5.05±0.77)mmol/L低于VB I组(6.00±1.14)mmol/L。结论对于有后循环系统缺血临床表现的老年患者,应更加重视症状、体征的特征性变化,而高血压等心脑血管病的危险因素以及发病时血糖的水平有助于我们做出准确的判断。

Objective To explore the difference of clinical manifestation between the patients with brain stem infarction and those with vertebrobasilar insufficiency （VBI）. Methods The clinical data of 14 patients with brain stem infarction and 95 ones with vertebrobasilar insufficiency were retrospectively analyzed. Results There were more symptoms, physical signs and hypertension incidence in patients with brain stem infarction, compared with those of VBI patients. After the admission,the levels of blood sugar in patients with brain stem infarction were higher than that in VBI patients. Conclusion For those elderly patients with the clinical manifestation of vertebrobasilar in- sufficiency, we should pay more attention to their neurological symptoms, physical signs, cardio/cerebrovascular risk factors and blood sugar level.