急性脑梗死伴早期意识障碍与梗死部位的关系研究

Study on Relationship between Acute Cerebral Infarction Complicated with Early Consciousness Disturbance and Infarction Site

目的了解脑梗死早期意识障碍的发生情况与梗死部位的相关性,探讨前、后循环梗死早期出现意识障碍的发生率,并进行相关影响因素的分析。方法使用成都卒中登记库2013年1月1日至2014年12月31日急性脑梗死患者数据,纳入首次发病、有头颅MRI资料,有不同程度早期意识障碍的患者。根据新发脑梗死部位将患者分为三组:前循环梗死组、后循环梗死组,前后循环同时梗死组。观察三组早期意识障碍的发生率、程度;分析不同部位脑梗死伴早期意识障碍的相关影响因素。结果不同部位脑梗死早期意识障碍发生率:前循环组12.4%(85/684),后循环组发生率10.9%(32/293),前后循环组发生率29.5%(13/44)。常见血管危险因素分析:高血压病:前后循环组84.6%(11/13);高脂血症:后循环组50.0%(16/32);糖尿病:后循环组53.1%(17/32)。结论早期出现意识障碍的脑梗死中,前后循环同时梗死组发生率最高,后循环组最低。高血压病前后循环同时梗死组多见。高脂血症、糖尿病后循环梗死组多见。

Objective To investigate the correlation between the occurrence of consciousness disorder and the location of infarction in the early stage of cerebral infarction, and to explore the incidence of consciousness disorder in the anterior and posteri- or circulation infarction, and to analyze the related influencing factors. Methods Data of patients with acute cerebral infarctionf- rom the Chengdu stroke registry base from January 1,2013 to December 31,2014 were used,and patients with first onset,head MRI data, and varying degrees of early consciousness disorders were included. The patients were divided into three groups according to the location of the new infarction： anterior circulation infarction group, posterior circulation infarction group, anterior and posterior circulation infarction group. The incidence and degree of early conscious disturbance in the three groups were observed ; The related influencing factors of cerebral infarction in different parts with early consciousness disorder were analyzed. Results The incidence of early conscious disturbance in different parts of cerebral infarction ：12. 4% in the anterior circulation group（85/684） ,10. 9% in the posterior circulation .group （32/293）, and 29. 5 % in the anterior and posterior circulation group （ 13/44 ）. Analysis of common vascular risk factors showed ：hypertension ：84. 6% in the anterior and posterior circulation group （ 11/13 ） ;hypedipidemia：50% in posterior circulation group（16/32） ;diabetes：53.1% in posterior circulation group（17/32）. Conclusion In the early cerebral in- farction patients with conscious disturbance, the incidence of infarction in the anterior and posterior circulation was the highest, and the lowest in the posterior circulation group. In hypertensive patients,incidence of infarction in both anterior and posterior circula-tion was more common,while in patients with hyperlipidemia and diabetes,infarction in posterior circulation was more common.