非膝状体动脉闭塞导致丘脑梗死临床特征

Clinical features of thalamic infarction caused by non-thalamogeniculate artery occlusion

目的 探索3条少见而特殊的丘脑动脉(丘脑结节动脉、丘脑穿通动脉、脉络膜后动脉)闭塞在病因学特征。方法 收集48例膝状体动脉闭塞和19例非膝状体动脉闭塞的患者,比较两组患者临床表现和病因学分型差异。结果 与膝状体动脉闭塞组相比,在症状学上,非膝状体动脉闭塞组表现为高级智能减退(0.00%vs 21.1%,χ^(2)=10.747,P=0.001),膝状体动脉闭塞组在偏身感觉障碍(75%vs 21.1%,χ^(2)=16.466,P<0.001)的比例高。在病因学上,非膝状体动脉闭塞组在大动脉粥样硬化型(29.17%vs 84.2%,χ^(2)=16.679,P<0.001)的比例高。在病灶体积上,非膝状体动脉组患者梗死体积较大(t=10.86,P<0.0001)。结论 非膝状体动脉闭塞引起的丘脑梗死有自身特征:症状学上以高级智能减退为主、在病因学上大动脉粥样硬化型为主,因此在临床上针对此类患者应加强大血管病变的筛查。

Objective To explore the clinical and etiological features of rare and special thalamic artery(thalamotuberal artery,thalamoperforating artery,and posterior choroidal artery)occlusion.Methods We included 48 patients with thalamogeniculate artery occlusion and 19 patients with non-thalamogeniculate artery occlusion to compare their clinical manifestations and etiological classifications.Results Compared with the thalamogeniculate artery occlusion group,the non-thalamogeniculate artery occlusion group showed a significantly higher percentage of decline in advanced cognition(0.00%vs 21.1%,χ^(2)=10.747,P=0.001),a significantly lower percentage of unilateral sensory disturbance(75%vs 21.1%,χ^(2)=16.466,P<0.001),a significantly higher percentage of large artery atherosclerosis in etiology classification(29.17%vs 84.2%,χ^(2)=16.679,P<0.001),and a significantly larger infarct volume(t=10.86,P<0.001).Conclusion Patients with thalamic stroke caused by non-thalamogeniculate artery occlusion are more likely to have decline in advanced cognition and large artery atherosclerosis.More attention should be paid to large vessel disease screening for such patients.