脑梗死部位与缺血性进展性卒中的关系

摘要

目的：探讨脑梗死部位与缺血性进展性卒中的关系，为早期识别进展性卒中提供可能的影像学依据。方法：回顾性分析发病48 h内入院治疗的653例脑梗死患者的病例资料，根据缺血性进展性卒中诊断标准，将其分为进展性卒中组（进展组155例）和非进展性卒中组（对照组498例）；按梗死部位分为侧脑室体旁梗死（A型）、分水岭梗死（B型）、单个脑叶或基底节或大面积脑梗死（C型）、脑干和/或小脑梗死（D型）4型，比较各型的发生率，对缺血性进展性脑卒中的相关因素进行Logistic回归分析，筛选其发生的危险因素。结果：进展组中A型进展性卒中发病率最高，其次为B型，与其他类型及对照组比较差异均有统计学意义（P<0.05）；同组其他类型间比较差异无统计学意义（P>0.05）。进展组高血压病史和颈部血管斑块形成发生率显著高于非进展组（P<0.05）；进展组入院时血糖、胆固醇、甘油三酯水平显著高于非进展组（P<0.05）。颈部血管斑块形成、入院时高血糖、梗死部位与缺血性进展性脑卒中的发生相关（P<0.05）。结论：颈部血管斑块形成、入院时高血糖、梗死部位与缺血性进展性脑卒中的发生相关。侧脑室体旁梗死、分水岭梗死较易进展。%Objective:To explore the relationship of the infarction region and the stroke in progression,and find the potential imaging evidence for discriminating the stroke in progression in earlier period. Method:The original data of 653 cases of cerebral infarction who presented within 48 hours of onset were retrospectively analyzed. According to the diagnostic criteria of stroke in progression(SIP),all the patients were divided into stroke in progression group(progressive group,155 cases)and non-progression stroke group(control group,498 cases). And according to the infarction region, they were divided into 4 types,such as the body of lateral ventricle infarction(type A),cerebral watershed infarction(type B),single lobe or basal ganglia or large-area cerebral infarction(type C),and brain stem and(or)cerebellar infarction (group D). Then,the incidence of various types were compared,the related factors of SIP were analyzed by logistic regression method for screening the risk factors. Result:In the progressive group,the incidence of type A was the highest than the other types,followed by type B,there were significant difference compared with other types and the control group (P<0.05),and no significant difference between the other types(P>0.05). The rate of having the history of hypertension and the formation of carotid plaque were significantly higher than them in the control group(P<0.05). The levels of blood glucose at admission,cholesterol,triglyceride were significantly higher than them in the control group(P<0.05). There were relevance between SIP with the formation of carotid plaque,the high level of blood glucose at admission and infarction region(P<0.05).Conclusion:There is relevance between SIP with the formation of carotid plaque,the high level of blood glucose at admission and infarction region. Around the body of lateral ventricle infarction and cerebral watershed infarction is easy to deteriorate.