大动脉粥样硬化型脑梗死与穿支动脉疾病型脑梗死的临床特点对比

Comparison of clinical features of large-artery atherosclerosis cerebral infarction and perforating artery disease type cerebral infarction

目的对比分析大动脉粥样硬化型脑梗死与穿支动脉疾病型脑梗死的临床特点。方法将90例大动脉粥样硬化型脑梗死患者作为观察组,90例穿支动脉疾病型脑梗死患者作为对照组,对两组患者的一般资料与临床特点进行对比分析。结果观察组患者的饮酒、吸烟率分别为43.33%、54.44%,依次高于对照组的27.78%、25.56%;观察组合并冠心病、脂代谢异常率分别为45.56%、58.89%,依次高于对照组的21.11%、37.78%;而对照组合并糖尿病率为65.56%,高于观察组的42.22%,差异有统计学意义(P<0.05)。观察组血浆氧化低密度脂蛋白水平[(687±169)μg/L]和循环内皮细胞计数[(9.0±1.7)×106/L]明显高于对照组,观察组一氧化氮水平[(77.4±21.1)μmol/L]则低于对照组,两组比较差异具有统计学意义(P<0.05)。结论大动脉粥样硬化型脑梗死的发病因素与饮酒、吸烟,合并冠心病、脂代谢异常等有较大关系,而穿支动脉疾病型脑梗死多与糖尿病有关。

Objective To study the clinical features of large-artery atherosclerosis cerebral infarction and perforating artery disease type cerebral infarction.Methods Ninety cases of large-artery atherosclerosis cerebral infarction were set as the observation group and 90 cases of perforating artery disease type cerebral infarction as the control group.The general data and clinical characteristics were performed the comparative analysis.Results The drinking and smoking rates in the observation group were43.33% and 54.44% respectively,which were in turn higher than 27.78%and 25.56%in the control group;the occurrence rates of complicating coronary heart disease and lipid metabolism abnormality in the observation group were 45.56%and 58.89%respectively,which were in turn higher than 21.11%and 37.78%in the control group;while the occurrence rate of complicating diabetes mellitus in the control group was 65.56%,which was higher than 42.22%in the observation group,the differences were statistically significant（P〈0.05）.Plasma oxidized low density lipoprotein and circulating endothelial cell count in the observation group were（687±169）g/L and（9.0±1.7）×10^6/L respectively,which were significantly higher than the normal level in the control group,the level of nitric oxide in the observation group was（77.4±21.1）mol/L,which was lower than that in the control group.The differences between the two groups were statistically significant（P〈0.05）.Conclusion The onset factors of large artery atherosclerosis cerebral infarction have larger relation with drinking,smoking,complicating coronary heart disease and lipid metabolism abnormality,while perforating artery disease type cerebral infarction is more related with diabetes.