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无症状脑梗死患者新发脑梗死的临床特点及相关因素分析
于海荣,滕继军,谢安木,李宏,孙妍萍
0
(青岛大学;青岛大学附属医院神经内科)
摘要:
【摘要】 目的 探讨无症状脑梗死(SBI)患者新发脑梗死的临床特点及相关因素的分析响。 方法 选择2018年1月~2018年6月在青岛大学附属医院神经内科住院的新发急性脑梗死(ACI)214例患者根据颅脑磁共振检查是否有SBI病灶分成SBI组(n=101)和非SBI组(n=113),收集同期的健康对照者87例(健康对照组)。比较SBI组患者不同病情程度的影响因素。观察SBI组和非SBI组患者TOAST病因学分型及各亚型分布特征,并对相关危险因素、临床表现等进行分析。比较3组C-反应蛋白(CRP)、血小板淋巴细胞比率(PLR)、神经元特异性烯醇化酶(NSE)的水平。 结果 SBI组和非SBI组TOAST病因学分型分布比较差异无统计学意义(P>0.05)。合并血管源性脑白质病变、糖尿病的脑梗死患者容易合并SBI;合并糖尿病、血管源性脑白质病变的SBI患者新发脑梗死病情更重。与健康对照组比较,SBI和非SBI组CRP、PLR、NSE升高,且SBI组比非SBI组高(P<0.05)。 结论 伴SBI的新发脑梗死病情更重,要重视对SBI的检出;加强对合并糖尿病、血管源性脑白质病变的SBI进行脑血管病预防治疗;监测CRP、PLR、NSE可能及时发现SBI病例,减轻SBI新发脑梗死的严重性。
关键词:  脑梗死  无症状  新发  短暂性脑缺血发作
DOI:
基金项目:山东省医药卫生科技发展计划(2013WS0261)
Clinical study of new cerebral infarction in silent brain infarction
YU Hairong,TENG Jijun,XIE Anmu,LI Hong,SUN Yanping
(Qingdao University;The Affiliated Hospital of Qingdao University)
Abstract:
【Abstract】 Objective To explore the clinical characteristics of new cerebral infarction in patients with asymptomatic cerebral infarction (SBI) and the influence of related factors. Methods From January 2018 to June 2018, 214 patients with new acute cerebral infarction (ACI) who were hospitalized in the Department of Neurology, Affiliated Hospital of Qingdao University were divided into two groups according to whether there was SBI focus in brain MRI (object n=101) and non SBI (object n=113). The distribution characteristics of the subtypes of toast in the two groups were observed, and the related risk factors and clinical manifestations were analyzed. 87 healthy controls (healthy control group) in the same period were collected for comparison. The levels of C-reactive protein (CRP), platelet lymphocyte ratio (PLR) and neuron specific enolase (NSE) were compared among the three groups. Results There was no significant difference in the distribution of TOAST type between the SBI group and the nonSBI group, and the proportion of large atherosclerotic type (LAA) was largest in both groups. The SBI group was more serious than the nonSBI group. Cerebral infarction patients with vascular white matter lesions or diabetes were easy to be combined with SBI. New cerebral infarction patients with SBI with diabetes or vascular white matter lesion were more serious. CRP, PLR and NSE were all increased in cerebral infarction, and SBI was higher than nonSBI. Conclusion The new cerebral infarction with SBI is more serious. We should pay more attention to the detection of SBI, strengthen the prevention and treatment of cerebrovascular disease for SBI with diabetes and vascular white matter disease. Monitoring CRP, PLR and NSE may find the cases of SBI in time, and reduce the severity of the new cerebral infarction of SBI.
Key words:  Brain infarction  Silent  New  Transient ischemic attack

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