两种不同类型桥脑梗死发病机制研究

Comparative Analysis of two Different Types of Pontine Infarction Pathogenesis

目的比较桥脑旁正中梗死与桥脑深部梗死的发病机制。方法 51例桥脑梗死患者根据头颅MRI表现分为桥脑旁正中梗死及桥脑深部梗死,对两组的病因,危险因素及基底动脉病变情况进行分析。结果 51例患者中桥脑旁正中梗死为34例,桥脑深部梗死17例。桥脑旁正中梗死中16例有基底动脉狭窄(狭窄率47.05%),桥脑深部梗死中7例有基底动脉狭窄(狭窄率41.17%),两组基底动脉狭窄率比较差异无统计学意义(P>0.05),但两组危险因素比较发现桥脑旁正中梗死合并糖尿病比例较高,差异有统计学意义(39.22%vs5.88%,P<0.05)。结论无论是桥脑旁正中梗死还是桥脑深部梗死都与基底动脉狭窄有关,糖尿病可能是桥脑旁正中梗死发生的高危因素之一。

Objective To compare the pathogenesis of two different types of pontine infarction, that paramedian pontine infarction and lacunar pontine infarction. Methods 51 cases of pontine infarction patients were divided into paramedian pontine infarctions and lacu- nar pontine infarctions according to the performance of MRI, The risk factors and basilar artery lesions of two groups were compared in order to guide treatment. Results 51 patients with pontine infarction were included, 34 with paramedian pontine infarction and 17 with lacunar pantine infarction, 16 patients with basilar artery stenosis among the paramedian pontine infarction （restenosis rate 47.05 % ）, 7 patients with basilar artery stenosis among the lacunar pontine infarction （rcstenosis rate 41.17 % ）, the basilar artery stenosis rate had no significant difference in two groups （ P 〉 0.05）, however, we found that paramedian pontine infarction accompanied by dia- betes with a higher proportion （39.22% vs 5.88%, P 〈 0.05）. Conclusions The medial pontine infarction even in patients with me- dial pontine lacunar infarct were mostly caused by basilar artery branch disease and was closely related with basilar artery stenosis, diabetes may be one of the risk factors that caused paramedian pontine infarction.