脑分水岭梗死与脑血管狭窄的相关临床研究

The Correlation Study of Cerebral Watershed Infarction and Cerebral Vascular Stenosis

目的探讨脑分水岭梗死（CWI）的临床表现及影像学特点，分析脑分水岭梗死与脑血管狭窄的相关性。方法分析38例CWI患者的症状和体征，CT、MRI、CTA、DSA改变，临床分型和病因。结果38例CWI患者的症状体征与病因及病变部位有关。CT／MRI证实皮层前型13例，皮层后型17例，皮层下型8例。以脑血管器质性病变为丰因者33例，其中颈内动脉狭窄或闭塞18例，大脑中动脉狭窄或闭塞11例。CWI多有血液成分的异常（如高脂血症、糖尿病、高同型半胱氨酸血症1。结论CWI临床表现取决于病变部位及病因；颈动脉狭窄或闭塞或动脉粥样硬化斑块形成是CWI主要病理基础、血液成分异常（如糖尿病、高脂血症、高同型半胱氨酸血症）也参与了CWI形成。

Objective To investigate the clinical manifestations and the etiology of cerebral watershed infarction （CWI）.Methods The clinical symptoms and signs and the CT/MRI characteristics and the clinical types and the etiology of 38 CWI cases were investigated.Results In the 38 CWI cases,the clinical symptoms and signs were associated with the causes and the regions of CWI;13 cases were precortical type, 17 cases were postcortical type, and 8 cases were subcortical type.In the 33 CWI cases where the main etiology was cerebral vascular pathological changes, 18 cases had internal carotid artery stenosis or carotid artery occlusion,and 11 had middle cerebral artery stenosis or occlusion;The patients with CWI almost possessed the abnormality of blood constituent （diabetes, hyperlipemia and increased blood viscosity）.Conclusion The clinical manifestations of the CW1 cases were deter- mined by the regions and the causes of CWI.The main causes were hypotension,carotid artery stenosis or occlusion, or atherosclerotic plaque of carotid artery,and the abnormality of blood constituent.