【摘要】 目的探讨大脑中动脉(MCA)深穿支梗死灶位置及数目与MCA动脉粥样硬化之间的关系。方法前瞻性收集2014年3月—2017年6月期间北京天坛医院脑血管病中心收治的急性脑梗死病人。经DWI证实,存在MCA深穿支供血区急性梗死灶的病人49例,其中男45例,女4例,年龄28~73岁,平均(55.5±10.6)岁。所有病人均于发病2周内行颅内大动脉3D高分辨MRI(HR-MRI)检查,即血管壁成像(VWI)。按照HR-MRI所示MCA有无斑块,将所有病人分为2组。采用Mann-Whitney U检验和χ~2检验分别比较2组之间脑梗死病灶位置和数目的差异。结果 2组间年龄、性别、高血压、糖尿病、高血脂等临床资料差异均无统计学意义(均P>0.05)。HR-MRI显示MCA有斑块病人30例(61.2%),MCA无斑块病人19例(38.8%)。MCA有斑块组梗死灶最低层面为第2.5(1.0,3.3)层,MCA无斑块组梗死灶最低层面为第3.0(2.0,4.0)层,2组间梗死灶最低层面差异有统计学意义(Z=-2.084,P=0.037)。MCA有斑块组中,深穿支单发病灶者19例(63.3%),多发病灶者11例(36.7%);MCA斑无块组中,19例均为单发病灶(100%)。2组间单发病灶数目差异有统计学意义(P<0.05)。结论 MCA动脉粥样硬化斑块与其深穿支供血区梗死灶的位置和数目有关,有助于进一步探讨深穿支区梗死的发病机制。更多还原

【Abstract】 Objective To evaluate relationship between atherosclerosis activity of middle cerebral artery(MCA) and location and number of deep perforating artery infarction in MCA territory. Methods We prospectively assessed acute ischemic stroke patients treated in Tiantan Comprehensive Stroke Center of Beijing Tiantan Hospital during March 2014 to June 2017. A total of 49 patients, ranging from 28 to 73 years(mean age, 55.5±10.6 years; 45 men) had acute ischemic stroke within lenticulostriate territory of MCA on diffusion-weighted imaging. Intracranial large vessel 3 D HR-MRI, namely vessel wall imaging, was performed in all patients within 2 weeks after stroke onset. Patients are divided into two groups according to presence of MCA plaque or not. Mann-Whitney U test and χ2 test were respectively applied for comparison of lesion location and lesion number between the two groups. Results Clinical characteristics such as age, sex, hypertension, diabetes mellitus, and hyperlipoidemia showed no significant differences(P>0.05). According to HR-MRI, 30(61.2%) patients had MCA plaque and 19(38.8%) patients did not. The lowest layer was 2.5(1.0, 3.3) for the former group and 3.0(2.0,4.0) for the latter group, and there was a significant difference between two groups(Z=-2.084, P=0.037). In the group with MCA plaque, 19(63.3%) patients had singular lesion, and 11(36.7%) had multiple lesions; while all patients had singular lesion in the group without MCA plaque(100%). There was a significant difference in the comparison of singular lesion number between two groups(P<0.05). Conclusion MCA atherosclerotic plaques are related to location and number of deep perforating artery infarction.It helps in understanding mechanisms in stroke.更多还原