老年脑梗死患者伴脑微出血的临床观察

目的探讨老年脑梗死患者伴脑微出血(CMB)的危险因素及治疗预后。方法连续入选2010年2～3月的100例老年脑梗死患者,根据MRI检查分为CMB组23例和无CMB组77例,记录一般临床资料、影像学表现及神经功能缺损评分。2组均给予丹红注射液治疗,无CMB组口服拜阿司匹林,14 d后再进行神经功能缺损评分及有效率的评价。结果与无CMB组比较,CMB组年龄更高,高血压和既往脑卒中患病率高,服抗血小板药物>3个月比例高(P<0.05)。CMB灶数目与腔隙性脑梗死灶数目及脑白质病变的程度呈正相关。治疗14 d后,无CMB组患者神经功能缺损评分低于CMB组(P<0.05),总有效率高于CMB组(P<0.05)。结论 CMB是由高龄、高血压及既往脑卒中等所致的血管壁病变。CMB可能在预测高血压患者发生脑出血的风险中产生作用。

Clinical character of cerebral microbleeds in elderly patients with cerebral infarction

Objective To investigate the risk factors,clinical therapy and prognosis of cerebral microbleeds in elderly patients with cerebral infarction.Methods One hundred elderly patients with derebral infarction were recruited consecutively.They were classified into two groups according to MRI.One group included the patients with cerebral microbleeds(CMB,23 patients) and the other group included the ones without CMB(77 patients).The data of age,risk factors,clinical manifestation, MRI,prognosis and NIHSS mark were collected.Both groups were treated with Danhong injection and the patients without CMB were treated with aspirin.After treatment for 14 days, their effectiveness was evaluated.Results The patients with CMB were older than those without CMB.The prevalence of hypertension,former stroke and use of oral antiplatelet drug were higher (P<0.05) and the effectiveness of treatment was lower(P<0.05) in CMB group.There were positive correlations between the number of CMB and the number of lacunar infarcts or severity of white matter changes.Conclusions CMB is a microangiopathy caused by old age,hypertension and former stroke.CMB is a risk factor for the encephalorrhagia in hypertension patients.