前循环急性多发与单发脑梗死病因分析

Difference of stroke etiological subtypes between acute multiple brain infarction (AMBI) and single brain infarction (ASBI) in the anterior circulation

目的分析前循环急性多发与单发脑梗死病因差异。方法纳入前循环急性脑梗死129例,根据磁共振弥散加权成像(DWI)病灶特点分为多发组和单发组,按TOAST分型标准对卒中病因进行分类。结果 69例多发脑梗死中大动脉粥样硬化性卒中44例,心源性栓塞13例,小动脉闭塞性卒中3例,其他原因所致的脑缺血性卒中4例,不明原因的脑缺血性卒中5例;60例单发脑梗死中大动脉粥样硬化性卒中16例,心源性栓塞5例,小动脉闭塞性卒中34例,其他原因所致的脑缺血性卒中2例,不明原因的脑缺血性卒中3例。多发组与单发组相比,多发组大动脉粥样硬化性卒中更常见(P=0.000),单发组小动脉闭塞性卒中更常见(P=0.000)。结论前循环急性多发脑梗死的主要病因是大动脉粥样硬化性卒中,急性单发脑梗死的主要病因是小动脉闭塞性卒中。

Objective To discuss the difference of stroke etiological subtypes between AMBI and ASBI in the anterior circulation. Methods In this prospective cohort study, the DWI data of 129 patients with acute cerebral infarction in the anterior circulation were assessed, in this prospective cohort study. The patients were divided into AMBI group and ASBI group according to the lesion patterns on DWI. The stroke etiological subtypes were determined according to the criteria of the Trial of Org 10172 in Acute Stroke Treatment（TOAST）. Results DWI showed that 69 patients had AMBI,60 patients had ASBI. In AMBI group, there were 44 patients with large artery atherosclerotic cerebral infarction, 13 with cardio embolism,3 with small-artery occlusion ,4 with stroke of other determined etiologies, and 5 with stroke of undetermined etiolo- gies; In ASBI group, there were 16 patients with large artery atherosclerotic cerebral infarction,5 with cardio embolism ,34 with small-artery occlusion ,2 with stroke of other determined etiologies ,and 3 with stroke of undetermined etiologies. The mos（ frequent cause of stroke was large-artery atherosclerosis in AMBI group and the most frequent cause of stroke was small-artery occlusion in ASBI group. Conclusions The main cause of AMBI in the anterior circulation is large-artery atherosclerosis, the main cause of ASBI in the anterior circulation is small-artery occlusion.