两种不同类型单侧孤立脑桥梗死发病机制

Two different types of unilateral isolated pontine infarction pathogenesis

目的探讨脑桥旁正中梗死(PPI)与脑桥深部小梗死(SDPI)的可能发病机制。方法选取2010—2016年收治的脑桥梗死患者395例,其中,PPI患者283例(PPI组),SDPI患者112例(SDPI组)。两组患者均行头MRI检查,比较两组患者一般临床资料、脑白质病变及血管周围间隙扩大程度。结果 SDPI组糖尿病比例、纤维蛋白原、空腹血糖及美国国立卫生研究院卒中量表(NIHSS)评分均低于PPI组,差异有统计学意义(P<0.05);SDPI组吸烟比例高于PPI组,差异有统计学意义(P<0.05);SDPI组脑白质病变分值高于PPI组,差异有统计学意义(P<0.05);SDPI组基底节区血管周围间隙扩大程度分值高于PPI组,半卵圆中心区分值低于PPI组,差异有统计学意义(P<0.05)。结论 PPI发病机制可能主要为穿支动脉疾病,其次为大动脉粥样硬化;而SDPI发病机制考虑为小动脉闭塞。

Objective To investigate the possibility of pathogenesis in paramedian pontine infarction（ PPI） and small deep pontine infarction（ SDPI）. Methods A total of 395 patients with acute isolated pontine infarction were admitted from 2010 to 2016. There were283 cases of PPI（ PPI group）,and 112 cases of SDPI（ SDPI group）. Two groups of patients were performed MRI,two groups of patients in general clinical data,cerebral white matter lesions,and degree of clearance around blood vessels expand were compared.Results The proportion of diabetes,fibrinogen,fasting glucose,and the national institutes of health stroke scale（ NIHSS） scores in SDPI group were lower than those in PPI group,the difference was statistically significant（ P〈0. 05）;the percentage of smoking in SDPI group was higher than that in PPI group（ P〈0. 05）;the cerebral white matter lesions score in SDPI group was higher than that in PPI group（ P〈0. 05）;the basal ganglia region around blood vessels expand clearance degree score in SDPI group was higher than that in PPI group,half egg circle center score was lower than that in the PPI group,and the differences were statistically significant（ P〈0. 05）. Conclusion PPI pathogenesis may be mainly perforators artery disease,followed by artery atherosclerosis;while SDPI pathogenesis consideration for small artery occlusion.