老年大脑前动脉供血区梗死的临床特征

Clinical features of anterior cerebral artery infarction in elderly patients

目的:探讨老年人大脑前动脉(ACA)供血区梗死患者的临床特征。方法:回顾性分析2019年4月—2022年12月收治的ACA供血区梗死患者69例,根据患者年龄分为老年组(≥60岁)40例和非老年组(<60岁)29例。比较不同侧别神经功能障碍情况和影像学差异。结果:老年组入院神经功能障碍评分(NIHSS)和言语功能障碍、失语、尿失禁、精神行为异常、情感障碍或抑郁的发生比例均高于非老年组,差异有统计学意义(P<0.05)。老年组胼胝体膝部+体部梗死比例高于非老年组,差异有统计学意义(P<0.05),但胼胝体膝部和体部发生梗死的比例比较,差异无统计学意义(P>0.05)。老年右侧梗死患者精神行为异常、情感障碍或抑郁、偏侧忽视发生比例高于左侧,左侧梗死患者言语障碍发生比例高于右侧梗死,差异均有统计学意义(P<0.05);梗死灶部位方面,右侧额极梗死比例高于左侧,差异有统计学意义(P<0.05)。结论:不同侧别老年ACA供血区梗死患者在神经功能障碍和梗死灶部位方面存在差异。

Objective:To analyze the clinical features of elderly patients with anterior cerebral artery(ACA)infarction of different sides.Methods:Sixty-nine patients with ACA blood supply area infarction admitted from April 2019 to December 2022 were retrospectively analyzed and divided into the elderly group(≥60 years old)and the non-elderly group(<60 years old),including 40 cases in the elderly group and 29 cases in the non-elderly group.The neurological dysfunction and imaging differences of different sides were compared.Results:The incidence of national institute of health stroke scale(NIHSS),speech dysfunction,aphasia,incontinence,mental behavior abnormality,depression and urinary incontinence in the elderly group was higher than that in the non-elderly group,and the difference was statistically significant(P<0.05).The incidence of corpus callosum infarction in the elderly group was higher than that in the non-elderly group(P<0.05).There was no significant difference in the incidence of corpus callosum infarction between knee and body(P>0.05).The incidence of mental behavior abnormality,emotional disturbance and hemineglect in elderly patients with right side infarction was higher than that of left side infarction,and the incidence of speech disorder in left side infarction was higher than that of right side infarction,the difference was statistically significant(P<0.05).The proportion of infarction in the right frontal pole was higher than that in the left(P<0.05).Conclusion:There are differences in neurological dysfunction and infarct location of ACA patients in different sides.