不同类型急性缺血性脑血管病患者脑微出血的差异研究

摘要

Objective To investigate the occurrence of cerebral micro hemorrhage in patients with different types of acute ischemic cerebrovascular disease.Methods 403 cases of acute cerebral infarction admitted to hospital from August 2013 to April 2015 were randomly selected and divided into group A (atherothrombosis,242 cases),group B (cardioembolism,46 cases),group C (small artery type cerebral infarction,83 cases),and group D (unexplained cerebral infarction,32 cases) according to TOAST typing method.51 healthy volunteers in our hospital at the same period were selected as control group.Cerebral micro hemorrhage of each group were observed and analyzed.Results The incidence of micro hemorrhage in patients with acute cerebral infarction was 48.14％,higher than 5.88％ in control group,with statistically significant difference (P＜0.05).In the four subgroups of acute cerebral infarction group,the incidence of micro hemorrhage in group C was the most significant,higher than that in other three groups (P＜0.05);the proportion of grade Ⅱ,Ⅲ,Ⅳ micro hemorrhage in group A were comparable;grade Ⅱ micro hemorrhage was more common in group B,D;grade Ⅳ micro hemorrhage was more common in group C.Conclusions The risk of cerebral micro hemorrhage in patients with different types of acute ischemic cerebrovascular disease is different,the incidence of cerebral micro hemorrhage in some types of patients during primary and recurrent process are not the same,which may be related to different disease mechanisms and risk factors of different types of patients,needs further in-depth study of a larger sample.%目的 探讨不同类型急性缺血性脑血管病患者脑微出血的发生情况.方法 随机选取2013年8月至2015年4月期间本院收治的急性脑梗死患者403例,按照TOAST分型方法将其分为A组(动脉粥样硬化性血栓形成)242例,B组(心源性脑栓塞)46例,C组(小动脉型脑梗死)83例和D组(不明原因脑梗死)32例,另选取本院同期体检健康者51例作为对照组,对各组的脑微出血发生情况进行观察分析.结果 急性脑梗死组患者脑微出血发生率为48.14％,远高于对照组(5.88％),差异有统计学意义(P＜0.05);在急性脑梗死四个分组中,以C组患者脑微出血发生率最为显著,远高于其他三组(P＜0.05);其中,A组患者脑微出血在Ⅱ级、Ⅲ级、Ⅳ级均有分布,比例相当;B组、D组患者则以Ⅱ级脑微出血较为常见,C组患者以Ⅳ级为主.结论 脑微出血在不同类型急性缺血性脑血管病患者中的发生风险不同,此外部分类型患者初发和复发过程中其脑微出血发生率也不尽相同,这可能与不同类型患者其相关致病机制及危险因素不同有关,有待于进一步扩大样本进行深入研究.