急性缺血性卒中CISS分型的亚型分析

Analysis of subtype of CISS typing in acute ischemic stroke

目的对急性缺血性卒中患者应用CISS分型方法进行亚型分析,归纳总结急性缺血性卒中的病因学特点。方法选择首发急性缺血性卒中患者500例,均具有完善的数字血管造影(DSA)、磁共振成像(MRI)、磁共振血管造影(MRA)及CT等影像学检查及其他病因学检查资料,根据患者病史、临床症状及各项辅助检查结果,采用CISS分型方法对每位患者进行亚型判定。结果 CISS亚型中大动脉粥样硬化性卒中占69%,其中以颅内外大动脉粥样硬化-穿支动脉闭塞病因所占比率最高为23%;穿支动脉性卒中占12%,心源性卒中占7%,其他病因性卒中占1%,病因不明性卒中占11%。不同性别间CISS各亚型构成比差异无统计学意义。结论急性缺血性卒中发病原因以大动脉粥样硬化型最为常见,其中尤以颅内外大动脉粥样硬化-穿支动脉闭塞原因比例最高。

Objective It is to analyze the subtype of the patients with acute ischemic stroke according to Chinese ischemic stroke subclassfication （CISS） criteria, thus to summarize the etiological charaeterictics of this disease. Methods 500 patients with acute ischemic stroke who had complete image examination data such as DSA, MRI, MRA and CT and other etiological examination data were recruited into this study. The patients were classified into subtypes by CISS typing method based on disease history, clinical symptoms and every assistance examination result. Results Of all the acute ischemic stroke patients 69% , 12% ,7% ,1% and 11% were classified as large artery atherosclerosis, penetrating artery disease, cardiogenic stroke, other etioligies and undeterminded etiology. The study also found the ratio of intraeranial or extracranial large artery atheroscle- rosis-penetrating artery embolism was the highest in the large artery atherosclerosls subtypes. There was no significant differ- ence in the proportion of every subtype of CISS between different gender. Conclusion The most common disease cause of acute ischemic stroke was large artery atherosclerosis in which the proportion of intracranial or extracranial large artery atherosclerosis-penetrating artery embolism was the highest.