脉络膜前动脉梗死的临床特征及预后分析

The clinical features and prognosis of anterior choroidal artery infarction

目的探讨脉络膜前动脉(AchA)区域梗死的临床特征及其预后情况。方法选取77例局限于Ach A供血区新发脑梗死患者,根据入院后1周内美国国立卫生研究院卒中量表评分将患者分为病情进展组35例和病情非进展组42例。观察两组患者危险因素、临床表现、血管影像特点及预后情况。结果高血压是Ach A梗死最常见的危险因素(P<0.05)。病情进展组患者合并高脂血症和糖尿病危险因素的比例高于病情非进展组(P<0.05);病情进展组肢体偏瘫出现频率高于病情非进展组(P<0.05);病情进展组同侧颈内动脉或大脑中动脉总狭窄率高于病情非进展组(P<0.05)。两组患者临床转归比较,差异无统计学意义(P>0.05)。结论偏瘫是AchA梗死最常见的症状,高血压是其最常见的危险因素,进展性AchA梗死与非进展性AchA梗死的预后无差异。

Objectives To investigate the clinical features and prognosis of anterior choroidal artery infarction. Methods Seventy-seven patients with isolated AChA infarctions were selected. The National Institute of Health Stroke Scale (NIHSS) scores in one week were evaluated. Patients were divided into two groups: the progress group (35 cases) and the non-progress group (42 cases) according to the NHISS scores. Risk factors, clinical manifestations, vascular imaging characteristics and prognosis of the two groups were analyzed. Results Hypertension is the most common risk factor of AchA infarction (P < 0.05). The progress group was more often associated with dyslipidemia, diabetes, hemiparesis and internal carotid artery or middle cerebral artery atheroma (P < 0.05). There was no statistically significant difference in the prognosis between the progress group and the non-progress group (P > 0.05). Conclusions Hemiparesis is the most common symptom of AchA infarction. Hypertension is the most common risk factor. There was no difference in prognosis between the two groups.