急性后循环脑梗死与前循环梗死患者血管病变特点和危险因素分析

Characteristics and risk factors of vascular lesions in patients with acute posterior circulation cerebral infarction and anterior circulation infarction

目的分析后循环脑梗死(PCI)和前循环梗死(ACI)的责任动脉和危险因素,比较两者之间的差异。方法对2015年1月至2017年8月年在苏州市立医院北区神经内科住院的资料完整的89例经MRI确诊的PCI或ACI患者的病因及危险因素进行比较。脑卒中的责任动脉分类根据TOAST分型的诊断标准。结果共入组89例,其中ACI 46例(53.5%), PCI 43例(46.5%)。两种梗死类型最常见的责任动脉是小动脉闭塞(49.4%),发生在PCI患者的65.1%和ACI患者的23.9%。在PCI组,最常见的是小动脉闭塞(65.1%);在ACI组,最常见的病因是大动脉粥样硬化(50.0%)。PCI组与ACI组比较差异有统计学意义(P<0.05)。栓塞引起的梗死患者在PCI(4.6%)中所占比例少于ACI患者(10.9%)比率,但差异无明显统计学意义(P>0.05)。两组的危险因素频率分析显示,PCI组的糖尿病和吸烟比例(51.2%&55.8%)明显较ACI组(33.3%&42.2%)高,组间差异有统计学意义(P<0.05)。高血压病、高脂血症、高同型半胱氨酸血症等危险因素两组间无明显差异。结论 PCI组和ACI组责任动脉有所不同,危险因素分布不同。

Objective To analyze the responsibility artery and risk factors of vascular lesions in posterior circulation cerebral infarction(PCI)and anterior circulation infarction(ACI),and compare the differences between them.Method We collect data from January 2015 to August 2017 in the Department of Neurology in North District of Suzhou Municipal Hospital.The etiology and risk factors of 89 cases of PCI or ACI diagnosed by magnetic resonance imaging were compared.The classification of responsibility arteries in stroke is based on the diagnostic criteria of toast classification.Results A total of 89 cases were included,among them ACI were 46 cases,PCI were 43 cases(46.5%).The most common responsibility arteries of the two types of infarction are small arterial occlusion(49.4%),which occurs in 65.1%of PCI patients and the 9%ACI.In the PCI group,the most common etiology was small arterial occlusion(65.1%);in ACI Group,the most common etiology was atherosclerosis(50%).There were statistically significant differences between PCI and ACI group(P<0.05).The proportion of patients with embolism-induced infarction in PCI(4.6%)was significantly smaller than that of ACI patients(10.9%),but there was no statistically significant difference(P>0.05).The frequency analysis of risk factors in two groups showed that the proportion of diabetes and smoking in PCI group(51.2%&55.8%)was higher than that of ACI Group(33.3%&42.2%),the difference between the two groups was statistically significant(P<0.05).There was no significant difference between the two groups,such as hypertension,hyperlipidemia,homocysteine and other risk factors.Conclusion The responsibility arteries of PCI group and ACI group are different,the distribution of risk factors is different.