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1、无高血压病史急性脑梗死患者脑内微出血的临床研究594ChinJNervMentDisVo1.35,No.10October2009?论着无高血压病史急性脑梗死患者脑内微出血的临床研究范玉华苏霭欣林慧雯黄家星曾进胜【摘要】目的探讨有,无高血压的急性脑梗死患者中脑内微出血(cerebralmicrobleeds,CMBs)的危险因素和影像学上分布特点的不同.方法连续性收集急性脑梗死患者,进行磁共振扫描,包括T.,T:加权相以及梯度回波序列(gradientechoTE,GRE—T).分析患者临床特点,MRI上脑白质病变的严重程度和CMBs病灶的分布特点.结果
2、共人选998例急性脑梗死患者,CMBs发生于273例患者,其中62例无高血压病史.在无高血压病史的急性脑梗死患者中CMBs发生率为18.5%(62/335),低于有高血压病史的急性脑梗死患者(211/663,31.8%,P<0.0001).无高血压患者的CMBs局限于皮层和皮层下者占40.3%(25/62),高于有高血压的患者(20.4%,43/211,P=0.001).脑白质病变的严重程度,人院时收缩压是无高血压病史急性脑梗死患者发生CMBs的独立危险因素.结论有高血压和无高血压的急性脑梗死患者CMBs分布部位有所不同,后者更多地集中于皮层和皮层
3、下.控制血压在有,无高血压病史的CMBs患者均必要.【关键词】脑内微出血GRE—T2高血压【中图分类号】R743.3【文献标识码】ACerebralMicrobleedsinacuteischemicstrokepatientswithandwithouthypertension.FANYuhua.SUOYah—nie,Wynnie,WONGKasing,ZENGJinsheng.DepartmentofNeurology,thefAffiliatedHospital,SunYat—senU-niversity,No.58Zhongshan2ndroad
4、,Guangzhou,510080.Tel:020—87755766—8253.,【Abstract】ObjectiveToinvestigatethedifferencesinriskfactorsanddistributionbetweencerebralmicrobleeds(CMBs)withandwithouthypertension.MethodsWeexaminedconsecutiveacuteischemicstrokepatientswhoweread?mittedtoageneralregionalhospitalwithstand
5、ardizedMRIprotocol,includingconventionMTl,andgradient—echoT2techniques.ClinicalandimagingcharacteristicsincludingseverityofwhitematterchangesanddistributioncharacteristicsofCMBswerecollectedamongallthepatients.ResultsNinehundredandninety—eightpatientswereexamined.CMBsweredetected
6、in273patients(273/998,27.3%),amongwhich62werefoundwithouthypertension(62/273,22.7%).TheincidenceofCMBsamongischemicstrokepatientswithouthypertension(62/335,18.5%)wassignificantlylowerthanthatinpatientswithhypertension(211/663,31.8%,P<0.0001).ThelocationofCMBsamongpatientswitho
7、uthypertensionwaslimitedincortical—subcorticalregionin40.3%(25/62),muchmorethanthatinpatientswithhypertension(20.4%,43/211,P=0.001).Fortheisehemicstrokepatientswithouthypertension,severityofWMCandsystolicbloodpressureonadmissionwerefoundasindependentpredictorsforCMBs.ConclusionsT
8、hedistributionofCMBsinacuteischemicstrok
