脑桥旁正中动脉与豆纹动脉粥样硬化型脑梗死的临床差异性研究

Clinical differences of ischemic stroke related to lenticulostriate arteries and paramedian pontinearteries caused by intracranial branch atheromatous diseases

目的探讨不同供血区域的2组穿支动脉粥样硬化型脑梗死的临床差异。方法连续人选自2008年1月22日至2011年10月13日于中山大学附属第三医院神经科住院治疗的213例穿支动脉粥样硬化型脑梗死患者为研究对象，均经头颅磁共振DwI确诊为穿支动脉供血区域梗死。根据DWI所示穿支动脉供血区域的不同将人选患者分为2组，即脑桥旁正中动脉组（PPA组，56例）与豆纹动脉组（LSA组，157例），对2组患者的临床特征进行比较。结果白质变性在LSA组与PPA组患者中均有较高的发生率，分别为85．4％和98．2％。PPA组与LSA组患者在平均住院日及磁共振所示白质变性方面比较差异有统计学意义（t=一2．044，P=0．045；X2=6．832，P=0．0091。多自变最Logistic回归分析得出PPA组与LSA组磁共振检杏所示伴有白质变性与不伴有白质变性的0R值为11．652，95％CI为1．483～91．529，P值为0．020。结论穿支动脉粥样硬化型脑梗死常同时伴有白质变性，但因供血区域的不同而各有特点。

Objective To investigate the clinical differences and the mechanism of ischemic stroke related to intracranial branch atheromatous diseases. Methods All 213 consecutive patients diagnosed with ischemie stroke related to intracranial branch atheromatous diseases by using diffusion-weighted imaging （DWI）, admitted to our hospital from January 22, 2008 to October 13, 2011, were studied. These patients were classified into paramedian pontine arteries group （PPA group, n=56） and lenticulostriate arteries group （LSA group, n=157） according to the DWI findings. The clinical characteristics were compared between the two groups. Results The differences on the mean length of hospital stay and white matter degeneration were statistically significant between PPA group and LSA group （t=-2.044,P=0.045; X2=6.832,P=0.009）. In univariate logistic regression analysis, the odds ratio （OR） of concomitant white matter degeneration comparing with the opposite was 11.652, 95%CI was （1.483-91.529） and P value was 0.020. Conclusion The ischemic stroke related to intracranial branch atheromatous diseases usually accompanies with concomitant white matter degeneration, and the characteristics are different resulting from different blood supplies.