摘要
目的为确定老年脑干梗死患者在病因、临床表现和影像学表现是否具有自身特点,对老年脑干梗死与中青年脑干梗死患者进行临床特点比较。方法在前瞻性收集的卒中资料库中选择脑干梗死患者的资料,根据年龄分为老年组67例（〉60岁）和中青年组36例（18--60岁）,对2组的临床资料,包括卒中危险因素,人口学特点,腹围,主要症状,血液生化指标及头颅磁共振（MRI）病变部位和血管造影结果进行比较分析;结果采用SPSS17.0进行统计分析。结果老年组合并周围血管病的比例（64/67 vs.17/36,95.5%vs.47.2%,P=0）,入院时NIHSS评分（4.2±1.3 vs.2.3±1.8,P=0）,单发脑桥梗死比例（60/67 vs.26/36,89.6%vs.72.2%,P=0.01）和椎基底动脉中重度狭窄（≥50%）的比例（32/67 vs.8/36,47.8%vs.22.2%,P=0.01）高于中青年组,而血浆同型半胱氨酸水平（5.2±4.8 vs.8.3±6.7,P=0.02）低于中青年组。结论老年脑干梗死患者的临床特点为单发脑桥梗死更为常见,神经功能缺损较重,合并颅内外动脉粥样硬化的比例更高。
Objective To compare the difference of clinical features of brain stem infarction（BSI） in the old patients and the younger ones, and explore the special characters of etiology, presentation and imaging in elderly. Methods The pro- spective clinical data of patients with stroke were reviewed. 103 cases of BSI were selected and were divided into elderly group （ age 〉 60, n = 67 ） and the contrast group （ 18 〈 age≤ 60, n = 36 ）. The clinical characteristics including the risk fac- tors of stroke, demographic characteristics, abdomen circumference, main symptoms, blood biochemical parameters, MRI and conventional angiography findings were compared between the two groups. The data of the two groups were compared by SPSS 17.0. Results In the elderly group and contrast group, the percent of peripheral vascular atherosclerosis were 64% （64/67） and 17 % （ 17/36）, P = 0 ; NIHSS at admission were 4.2± 1.3 and 2.3± 1.8, P = 0 ;rate of monofocal pans infarction were 89.6% （ 60/67 ） to 72.2% （ 26/36 ）, P = 0.01 ; rate of serious vertebrobasilar artery stenosis （ t〉 50% ） were 47.8 （32/67） to 22.2% （8/36）, P = 0.01 ; the level of serum homocysteine were 5.2 ± 4.8 and 8.3 ± 6.7, P = 0.02）, respectively. Conclusion The monofocal pons infarction was common in the elderly patients, usually with severer neurologic functional impairment;most of them were combined with intracranial and extracranial artery atherosclerosis.
出处
《中华全科医学》
2014年第12期1911-1913,共3页
Chinese Journal of General Practice
基金
浙江省温州市科技计划项目(2012S0171)
关键词
脑干
脑梗死
年龄
Brain stem
Cerebral infarction
Age
作者简介
通讯作者：张征，E-mail：zhangzhengwz@126．com
