伴颅内外动脉狭窄或闭塞的分水岭脑梗死类型分析

目的探讨由颈内动脉(ICA)或大脑中动脉(MCA)狭窄或闭塞引起的分水岭脑梗死(WSI)的梗死类型及发病机制。方法 81例急性WSI患者根据责任血管分为ICA组(53例)及MCA组(28例)。根据MRI检查结果对两组梗死类型进行分析比较。结果 ICA组皮质前型及皮质前型+内WSI+皮质后型的比率显著高于MCA组(均P<0.05)。结论合并颅内外血管狭窄或闭塞WSI类型以内WSI及皮质后型梗死最常见。ICA病变患者WSI皮质前型常见,其发病机制可能为血流动力学障碍;MCA病变患者WSI皮质上型及合并融合性病灶多见,其机制可能为微栓子对远端血管的微栓塞。

Type analysis of cerebral watershed infarction accompanied with intracalvarium and extracalvarium artery stenosis or occlusion

Objective To investigate infarct patterns and mechanisms of cerebral watershed infarction(WSI)accompanied with stenosis or occlusion of intemal carotid artery(ICA) or middle cerebral artery(MCA).Methods The 81 patients were divided into ICA(53 cases) group and MCA group(28 cases) according to the responsible blood vessels.According to the results of skull MRI,the WSI types in the two groups was analyzed and compared.Results The rate of anterior WSI and anterior WSI+IWSI+posterior WSI in the ICA group were significantly higher than those in MCA group(all P<0.05).Conclusions The IWSI and posterior WSI are most common in types of WSI accompanied with intracalvarium or extracalvarium artery stenosis or occlusion.Anterior WSI is more common in ICA lesion patient,and the machanism hemodynamic.The MCA lesion patient is prone to cortex upper WSI and merged lesion,and the mechanism is that the micro embolus embolismed romate blood vessels.