内囊后肢梗死的临床特征及危险因素

Risk factors and clinical features of posterior capsular infarction

目的探讨内囊后肢梗死患者的临床特征及危险因素。方法选择局限于内囊后肢的梗死患者94例,以同期年龄相近、性别相同94例未分类脑梗死患者为对照,比较两组危险因素分布的差异。并进一步对内囊后肢梗死患者亚组的危险因素进行比较,即进展性运动障碍组与非进展性组以及白质疏松与无白质疏松组、有多发腔隙性脑梗死(LI)组与无多发LI组的危险因素分布。结果内囊后肢梗死组患者的高血压患病率、吸烟率、高同型半胱氨酸血症(Hhcy)率较未分类脑梗死组高(P<0.05)。进展性运动障碍组与非进展组的危险因素比较,无显著差异(P>0.05)。结论内囊后肢梗死大多数为穿支动脉病变所致,高血压、吸烟、Hhcy是内囊后肢梗死的主要危险因素。内囊后肢梗死容易发生进展性运动功能障碍及预警综合征,其病理机制与内囊后肢固有的穿支动脉病变以及运动纤维分布特征有关。

Objective To study the risk factors and clinical features of posterior capsular infarction. Method 94 patients with infarct restricted to posterior limb of the internal capsule were included. The control group consisted of 94 patients with non-classified cerebral infarction. The distribution of risk factors in both groups was compared. The risk factors between the group of progressive motor deficits and the group of non-progressive motor deficits , the group with leukoaraiosis and the group without leukoaraiosis, and the group with multiple lacunar infarction （ LI ） and the group without multiple LI were compared. Results The proportion of smokers, the incidence of hypertension and hyperhomocysteinemia （ Hhey ） were higher in posterior capsular infarct group than in control group （ 53.2vs35.1, 70.2vs52.1, 67.0vs51.1, P〈0.05 ） . The risk factors between the group of progressive motor deficits and the group of non-progressive motor deficits didn＇t differ significantly （ P〉0.05 ） .Conclusion Posterior capsular infarction is major caused by perforating artery lesions . Hypertension, smoking and Hhcy are the major risk factors for posterior capsular infarction. Posterior capsular infarct tends to manifest progressive motor deficits and capsular warning syndrome （ CWS ） , the pathogenesis of which are associated with perforating artery lesion and the intrinsic nerve fibers distribution of posterior limb of the internal capsule.