引用本文:宋成福,王佳君,冯建玉,张晓林,马继明,刘翔宇,王 静.大面积脑梗死104例临床特点及病因分析[J].中国临床新医学,2013,6(2):112-114.
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大面积脑梗死104例临床特点及病因分析
宋成福,王佳君,冯建玉,张晓林,马继明,刘翔宇,王 静
200093 上海,上海市杨浦区安图医院神经内科
摘要:
[摘要] 目的 分析104例大面积脑梗死临床表现、影像学特点及发病因素,为预防梗死发生提供依据。方法 104例大面积脑梗死患者行心电图、超声心动图、CT\CTA或MRI\MRA、经颅多普勒及颈部血管超声检查,分析大面积脑梗死的部位、闭塞血管及其病因。结果 心源性脑栓塞69例(占66.3%),其中冠心病39例,陈旧性心肌梗死16例,风心病7例,扩张性心肌病3例,甲亢性心脏病2例,肥厚性心肌病1例,心肌致密化不全1例。104例中并发心房纤颤63例(60.6%),并发高血压病75例(72.1%)。结论 心房纤颤、心源性脑栓塞是大面积脑梗死的重要病因。在大动脉粥样硬化狭窄基础上,动脉-动脉栓塞是大面积脑梗死的另一发病原因。
关键词:  大面积脑梗死  病因  心房纤颤  心源性脑栓塞
DOI:10.3969/j.issn.1674-3806.2013.02.06
分类号:R 743.33
基金项目:上海市杨浦区2012年度鼎元资金资助项目[编号:(2012)4号]
The clinical character and cause analysis of 104 massive cerebral infarction patients
SONG Cheng-fu,Wang Jia-jun,FENG Jian-yu,et al.
Department of Neurology,Antu Hospital,Shanghai 200093,China
Abstract:
[Abstract] Objective To investigate the clinical manifestations, clinical imaging features and related risk factors of 104 massive cerebral infarction patients, and to provide the basis for the prevention of large area cerebral infarction.Methods By reviewing the records of 104 massive cerebral infarction patients who had been performed ECG, echocardiogram, computetized tomography, magnetic resonance imaging or angiography, transcranial Doppler, and Carotid color Doppler ultrasound evaluation,both the site of infarctions and the causes of vascular occlusion were investigated.Results Among the 104 massive cerebral infarction patients, 69 patients(66.3%) had cardiogenic cerebral embolism, including 39 cases of coronary heart disease, 16 cases of old myocardial infarction, 7 cases of rheumatic heart disease, 3 cases of dilated cardiomyopathy, 2 cases of hyperthyroid heart disease, and 1 case of myocardial noncompaction. 63(60.6%) patients had atrial fibrillation,and 75 patients(72.1%) had hypertension.Conclusion Both atrial fibrillation and cardiogenic cerebral infarction are the most important cause of massive cerebral infarction, and artery-artery embolization is its another important cause on the basis of the artery stenosis.
Key words:  Massive cerebral infarction  Cause of disease  Atrial fibrillation  Cardiogenic cerebral embolism