急性孤立性脑桥梗死48例病因分型分析

摘要

Objective To analyze the classification of etiology in 48 patients with acute isolated pontine infarction (IPI),a special subtype of ischemic stroke,according to the characteristics of Chinese ischemic stroke subclassification (CISS) and Kumral ischemic stroke subclassification.Methods The basic characteristics,risk factors,clinical manifestations of 48 acute IPI patients were analyzed according to the CISS and Kumral ischemic stroke subclassification.Results Hypertension (70.83 ％),smoking (64.58 ％),hyperlipidemia (50.00 ％),and abnormal glucose metabolism (37.50％) were the major risk factors for acute IPI.Of the 48 acute IPI patients,38 (79.17％) manifestated as hemiplegia and 15 (31.25％) manifestated as dizziness,33 (68.75％) were diagnosed as paramedian pontine infarction,a most common location of IPI,16 (33.33％) were diagnosed as large artery occlusion,a major subtype of IPI,according to the Kumral ischemic stroke subclassification,17 (35.42％) were diagnosed as intracranial and extracranial large artery atherosclerosis according to the CISS (P=0.830).Conclusion IPI is mainly manifested as paramedian pontine infarction.Large artery occlusion according to the Kumral ischemic stroke subclassification and intracranial and extracranial large artery atherosclerosis according to the CISS are the major subtypes of IPI.IPI is diagnosed when a large part of brainstem is involved.%目的 急性孤立性脑桥梗死(IPI)是一种特殊的脑卒中亚型,病因分型有其亚型特点.本研究分析比较中国缺血性卒中亚型(CISS)和Kumral分型的特点.方法 选择48例IPI患者,对其基本特征、危险因素、临床表现进行分析,依据CISS病因分型和Kumral分型进行分析比较.结果 48倒入选患者中,高血压、吸烟、高脂血症、糖代谢异常是前4位危险因素,分别为70.83％、64.58％、50.00％和37.50％.临床表现为肢体无力38例(79.17％),头晕15例(31.25％).脑梗死部位以腹内侧旁中央为主,33例(68.75％).Kumral分型中大动脉闭塞性疾病型16例(33.33％),是主要的亚型.CISS分型中颅内外大动脉粥样硬化型者17例(35.42％),两者比较无统计学差异(x2=0.046,P=0.830).结论 IPI发病部位以腹内侧旁中央为主,Kumral分型的大动脉闭塞性疾病型和CISS病因分型的颅内外大动脉粥样硬化型是其主要的病因亚型.支持IPI为大范围脑干缺血的一部分.