【摘要】 目的:探讨前循环血管(颈内动脉颅内段和大脑中动脉)狭窄与老年患者腔隙或腔隙性脑梗死(腔梗)发生的相关性。方法:回顾性分析2016年5月—2017年8月于我院神经内科因颅内动脉粥样硬化、缺血性脑梗死等就诊的74例老年患者的影像资料,患者均行头颅MRI或CT平扫及磁共振血管成像检查。根据前循环血管有无狭窄、狭窄分布及狭窄程度分组,比较各组脑内腔隙或腔梗发生情况有无差异,并进行相关性分析。结果:63例大脑前循环血管狭窄的老年患者中发生腔隙或腔梗49例(49/74,66.2%),11例无前循环血管狭窄的老年患者中出现腔隙或腔梗4例(4/74,5.4%),前循环血管有无狭窄与腔隙或腔梗的发生存在相关性(χ~2=5.996,P=0.014)。25例前循环血管单侧狭窄者发生腔隙或腔梗16例(16/63,25.4%),38例前循环血管双侧狭窄者发生腔隙或腔梗33例(33/63,52.4%),血管狭窄单、双侧分布显著影响脑内腔隙或腔梗的发生(χ~2=4.552,P=0.033)。前循环血管狭窄程度不同分级间发生腔隙或腔梗的差异无统计学意义(χ~2=2.550,P=0.466)。结论:颈内动脉颅内段及大脑中动脉狭窄与老年患者腔隙或腔梗的发生存在关联性,且双侧血管狭窄患者发生腔隙或腔梗的危险性高于单侧狭窄者。更多还原

【Abstract】 Objective: To investigate the association between anterior circulation artery(intracranial carotid artery or middle cerebral artery) stenosis and lacune or lacunar infarction in elderly patients. Methods: The imaging data of 74 elderly patients with intracranial artery atherosclerosis and ischemic cerebral infarction in our hospital from May 2016 to August 2017 were retrospectively analyzed. All patients underwent brain MRI or CT plain scan, as well as magnetic resonance angiography(MRA).The association between anterior circulation artery stenosis, vascular stenosis distribution, vascular stenosis degree and lacune or lacunar infarction was analyzed. Results: There were 49 cases of lacune or lacunar infarction in 63 elderly patients with anterior cerebral circulation artery stenosis(49/74, 66.2%), and only 4 cases of lacune or lacunar infarction in 11 patients without anterior circulation artery stenosis(4/74, 5.4%). There was a correlation between the anterior cerebral circulation artery stenosis and the occurrence of lacune or lacunar infarction(χ~2=5.996, P=0.014). There were 16 cases of lacune or lacunar infarction in 25 patients with unilateral anterior circulation artery stenosis(16/63, 25.4%), and 33 cases of lacune or lacunar infarction in 38 patients with bilateral anterior circulation artery stenosis(33/63, 52.4%). There was a correlation between the vascular stenosis distribution and lacune or lacunar infarction occurrence(χ~2=4.552, P=0.033). There was no significant difference between the different degrees of anterior circulation artery stenosis(χ~2=2.550, P=0.466). Conclusions: The correlation between intracranial carotid artery or middle cerebral artery stenosis and lacunar infarction or lacune in elderly patients may exist. Risk for lacunar infarction or lacune is higher in patients with bilateral artery stenosis than in patients with unilateral artery stenosis.更多还原