脑桥梗死的临床特点及预后的相关性研究

Research of correlation between clinical manifestation and prognosis of pontine infarction

目的研究脑桥梗死的危险因素、临床表现、神经影像学改变及预后。方法回顾性分析100例脑桥梗死患者的临床资料,包括:高危因素、临床表现、影像学检查及预后。结果高危因素:高脂血症、高血压、糖尿病、吸烟。主要病因为动脉粥样硬化。主要临床特点:眩晕、病灶对侧的中枢性面瘫和肢体瘫痪、构音障碍、偏身麻木、球麻痹、眼震、复视、意识障碍等。按照头颅磁共振成像(MRI)横轴位上的病灶位置,腹内侧梗死49例,腹外侧梗死31例,被盖部梗死13例,双侧梗死7例。腹内、外侧梗死起病后30 d后神经功能缺失症状较前好转,差异具有统计学意义(P<0.01)。双侧脑桥梗死改良Rankin量表(m RS)评分较其余各组高,差异具有统计学意义(P<0.05)。结论动脉粥样硬化是脑桥梗死患者最常见的病因,眩晕、感觉运动障碍、构音障碍、球麻痹是常见的临床特点,脑桥梗死病灶多位于腹侧,不同部位范围影响患者预后。

Objective To research risk factor, clinical manifestation, neuroimaging change and prognosis of pontine infarction. Methods A retrospective analysis was made on clinical data, including high risk factor, clinical manifestation, imaging examination and prognosis, of 100 patients with pontine infarction. Results High risk factors included hyperlipidaemia, hypertension, diabetes mellitus, and smoking. Atherosclerosis was the main pathogenesis. Main clinical manifestations included dizziness, central facial paralysis and acroparalysis in opposite of lesion, dysarthria, hemianesthesia, bulbar paralysis, nystagmus, diplopia, and disturbance of consciousness. Transverse lesion location of brain magnetic resonance imaging（MRI） showed 49 cases in ventromedial infarction group, 31 eases in ventrolateral infarcts group, 13 cases in tegmentum infraction group, and 7 cases in bilateral infarction group. Neurologic deficit symptoms were improved after 30 d of ventromedial and ventrolateral infarction onset, and the difference had statistical significance （P〈0.01）. Bilateral infarction group had higher modified Rankin scale （mRS） score than the other groups, and their difference had statistical significance （P〈0.05）. Conclusion Atherosclerosis is the main pathogenesis of pontine infarction patients. Dizziness, sensorimotor dysfunction, dysarthria, and bulbar paralysis are common clinical manifestations. Ventral branches are main onset location of pontine infarction. Different locations influence their prognosis.