大脑中动脉深穿支单个腔隙性梗死临床特点及抗血小板药物疗效研究

Study of antiplatelet drugs therapy on single lacunar infarction in middle cerebral artery

目的:探讨大脑中动脉深穿支单个腔隙性梗死病灶的临床特点及抗血小板药物疗效。方法:收集2014年1月至2015年10月在北京市海淀医院神经内科住院的72 h以内发生大脑中动脉(middle cerebral artery,MCA)深穿支供血区域单个腔隙性梗死患者60例,将其根据梗死部位及载体动脉是否存在病变分为2组:腔隙性脑梗死伴有MCA病变组和腔隙性脑梗死不伴有MCA病变组,分别对这2组的病人进行脑血管病危险因素(性别、年龄、高血压、血压变异性、糖尿病、冠心病、脑卒中、吸烟)、临床特点(NIHSS评分、白质高信号)及抗血小板药物治疗3月后m RS评分比较。结果:两组在高血压、糖尿病、冠心病、脑卒中、吸烟、血压变异性、NIHSS、白质高信号及抗血小板物治疗3月后m RS方面有统计学差异(P<0.05)。结论:根据梗死部位及MCA病变,提示了MCA深穿支单个腔隙性梗死临床特点、病因及发病机制的多样性。因此需采取不同的治疗措施。

Objective： To investigate the clinical characteristics and effect of antiplatelet drugs therapy on single lacunar infarction. in middle cerebral artery. Methods： A total of 60 patients with single lacunar infarction in middle cerebral artery within 72 hours occurred between January 2014 and October 2015 in Department of Neurology in Haidian Hospital of Beijing.We classified the patients into two groups according to leison location： single lacunar infarction with MCA disease group and single lacunar infarction without MCA disease group.We compared the two groups of patients with cerebral vascular disease risk factors （gender, age, hypertension, blood pressure variability, diabetes, coronary heart disease, stroke, smoking） and clinical characteristics （NIHSS and mRS, white matter）. Results： There were statistical difference in hypertension, diabetes, coronary heart disease, stroke, smoking, blood pressure variability, NIHSS and mRS, white matter signal （P〈0.05） between the two groups. Conclusion： The difference in clinical characteristics, etiology and pathogenesis in patients with single lacunar infarction with MCA disease suggest the diversity of MCA perforating single lacunar infarction. So it is necessary to take different measures to treat.