鲁西南地区青年缺血性脑卒中脑血管狭窄分布特征

Distribution of cerebral artery stenosis in young adults with ischemic stroke in southwest of Shandong province

目的分析鲁西南地区青年缺血性脑卒中患者的脑血管狭窄分布特征。方法收集100例45岁以下青年卒中患者为青年组,>45岁100例中老年患者作为对照,所有患者均经神经影像学、颈部血管彩超、TCD等检查,并进行DSA检查,分析两者脑血管狭窄分布特征。结果青年组及中老年组脑血管狭窄发生率分别为85%及88%。青年组颅内动脉病变60例(70.6%),颅外动脉病变10例(11.8%),颅内外动脉同时受累15例(17.6%);中老年组颅内动脉病变35例(39.8%),颅外动脉病变40例(45.5%),颅内外动脉同时受累13例(14.7%)。青年组轻度狭窄60例(60%),中度狭窄30例(30%),重度狭窄或闭塞10例(10%),中老年组轻度狭窄20例(20%),中度狭窄35例(35%),重度狭窄或闭塞45例(45%)。结论颅内外脑供血动脉狭窄或闭塞是脑梗死最主要的发病原因之一,青年患者以颅内动脉病变多见,中老年患者以颅外动脉病变多见,中老年患者脑血管狭窄程度较青年组重。

Objective To investigate the distribution of cerebral artery stenosis in young adults with ischemic stroke in southwest of Shandong province. Methods We included 100 young adults （〈45 years old） with ischemic stroke, 100 patients （〉45 years old） were recruited as control group. All the patients were examined with digital subtraction angiography （DSA）. The distribution of cerebral artery stenosis was investigated. Results The rate of cerebral artery stenosis in youth group and middle-age and elderly group was 85 % and 88 %, respectively. In youth group, 60 cases （70.6 % ） had only intraeranial artery le- sions, 10 cases （11.8 %） bad only extracranial artery lesions, 15 cases （17.6 %） had both intracranial and extracranial lesions. In middle-age and elderly group,35 cases （39.8%） had only intracranial artery lesions,40 eases （45.5%） had only extracranial ar- tery lesions, 13 cases （14.7%） had both intracranial and extracranial lesions. Conclusion It is suggested that the intracranial and extracranial cerebral artery stenosis or occlusion is the most important cause of cerebral infarction. Youth patients have main intracranial arterial lesions,while elderly patients have extracranial arterial lesions mainly.