后循环梗死的临床特点及危险因素分析

摘要

目的：阐明后循环梗死常见临床症状、体征及危险因素。方法分析2008年10月-2011年10月在本院神经内科住院的急性后循环梗死患者61例资料。结果患者常见的症状头晕（54.1％）、偏侧肢体无力（45.9％）、恶心及呕吐（39.3％）和言语不清（31.1％）；少见症状为视物成双（4.9％）、抽搐（4.9％）及记忆障碍（4.9％）。常见的体征为单侧或双侧肢体运动障碍（45.9％）、共济失调（29.5％）、交叉性瘫痪（3.3％）和眼球活动障碍（4.9％）。在所调查的危险因素中，高血压（72.1％）、高脂血症（63.9％）、糖尿病（36.1％）、既往卒中史（31.2％）及心脏病（27.9％）。结论后循环梗死临床表现复杂，常见的症状为头晕、偏侧肢体无力、恶心及呕吐、言语不清，常见体征为肢体运动障碍，高血压为后循环梗死的主要危险因素，特征性临床表现及体征有助于后循环梗死的诊断及治疗。%Objective To describe the clinical features and risk factors of patients with posterior circulation ischemic stroke. Method 61 patients with posterior circulation ischemic stroke admitted in our department during 2008.10-2011.10 were analyzed retrospectively. All patients were undertaken MRI on admission and responsible lesions were identified at the posterior circulation territories.The patients'clinical symptoms, signs and risk factors were evaluated. The relationships between lesion locations and clinical characteristics and the distribution of risk factors were analyzed. Results The common symptoms of posterior circulation ischemic stroke were dizziness (54.0%),unilateral limb weakness (45.9%),nausea and vomiting (39.3%),speech difficulty (31.1%). The rare symptoms are diplopia (4.9%), seizure (4.9%) and dysmnesia (4.9%). The common signs of posterior circulation ischemic stroke were unilateral or bibateral limb weakness (45.9%) and ataxia (29.5%). The incidence of crossed paralysis,eye movement disorder was low (3.3%, 4.9%).Among the investigated risk factors, hypertension (72.1%), hyperlipidemia (63.9%), hyperglycemia (36.1%), cardiac disease (27.9%) and stroke history (31.2%) were the most prevalent ones. Conclusion The clinical features of patients with posterior circulation ischemic stroke were complicated. The common symptoms of posterior circulation ischemic stroke were dizziness,unilateral limb weakness,nausea and vomiting, and speech difficulty. The common signs of posterior circulation ischemic stroke was unilateral or bibateral limb weakness. Hypertension was the common risk factors of posterior circulation infarction. Distinctive symptoms can help to diagnose the posterior circulation ischemic stroke.