【摘要】 目的探讨前循环和后循环脑梗死的常见危险因素差异,为临床病因学诊断和治疗提供参考。方法本研究入选于2013年11月—2015年3月在天津医科大学宝坻临床学院住院的急性脑梗死患者170例,前循环脑梗死者116例、后循环者54例。分析两组间常见危险因素的差异。结果前循环梗死组高同型半胱氨酸血症有69例(59.5%),后循环梗死组有18例(33.3%),差异有统计学意义(χ~2=10.084,P=0.002);同样两组间血浆同型半胱氨酸水平的差异有统计学意义[(18.40±6.92)μmmol/L vs(15.02±6.89)μmmol/L,P=0.003]。前循环梗死组TOAST分型为大动脉粥样硬化型67例(57.8%)、心源性栓塞型9例(7.8%)、小动脉闭塞型40例(34.5%);后循环梗死组分别有21例(38.9%)、4例(7.4%)、29例(53.7%),两组间差异有统计学意义(χ~2=5.834,P=0.016)。两组间性别、年龄、高血压、糖尿病、冠心病、心房纤颤、吸烟、饮酒、血脂、纤维蛋白原、白细胞计数、血钾的比较差异无统计学意义(P>0.05)。结论前循环脑梗死患者高同型半胱氨酸血症的发病率及血浆同型半胱氨酸水平均较后循环者高;TOAST分型中大动脉粥样硬化型脑梗死更多发生在前循环者,而小动脉闭塞型在后循环者较多。更多还原

【Abstract】 Objective To investigate the differences of the risk factors for anterior circulation and posterior circulation infarction and to provide reference for cerebral infarction clinical etiological diagnosis and treatment. Method 170 cases of acute cerebral infarction were treated in Bao Di Clinical College of Tianjin Medical University from November 2013 to March 2015 and were divided into anterior circulation group(116 cases)and posterior circulation group(54 cases). Investigate the differences of the common risk factors for the two groups. Result Rate of hyperhomocysteinemia in anterior circulation group 59.5%(69/116)was significant higher than 33.3%(18/54)in posterior circulation group. The plasma homocysteine levels in anterior circulation group were significantly higher than those in posterior circulation group[(18.40±6.92)ummol/L vs(15.02±6.89)ummol/L, P=0.003). Compared with the posterior circulation group, anterior circulation group trended to increase in large artery atherosclerosis(67/116 VS 21/54)of the TOAST classification, cardiac embolism(9/116 VS 4/54)and decrease in small artery occlusion(40/116 VS 29/54). The gender, age, hypertension, diabetes, coronary heart disease, atrial fibrillation, smoking, drinking, lipid, fibrinogen, white blood cell count, potassium were similar between the two groups. Conclusion The increased level of plasma homocysteine is closely associated with anterior circulation infarction. In subtypes of the TOAST classification, more anterior circulation infarction caused due to large artery atherosclerosis. And more small artery occlusion exist in posterior circulation infarction.更多还原