缺血性心力衰竭合并急性分水岭脑梗死患者的临床分析

目的探讨缺血性心力衰竭合并急性分水岭脑梗死的机制和临床特点。方法回顾性分析1998年9月~2004年9月入住我院的14例缺血性心力衰竭合并急性分水岭脑梗死患者的临床特点及头颅CT和(或)MRI特征。结果脑分水岭区最易受体循环低血压或有效循环血量的影响,缺血性心力衰竭患者存在动脉粥样硬化的病理基础,心肌收缩力下降,心脏排血量减少,导致脑灌注量减少而发生急性分水岭脑梗死。结论缺血性心力衰竭患者易合并分水岭脑梗死。

Clinical analysis of cases of ischemic heart failure combined with acute cerebral watershed infarction

Objective To study the mechanism and clinical characteristics of ischemic heart disease-induced heart failure combined with acute cerebral watershed infarction. Method The clinical characteristics and cerebral CT or/and MRI of 14 cases of ischemic heart disease-induced heart failure combined with acute cerebral watershed infarction were analyzed retrospectively. Results The area of cerebral watershed is farthest from heart and is the distal part of the artery, so low blood pressure of body circulation or effective circulatory blood volume is apt to affect it. The patients with ischemic heart disease-induced heart failure had the pathological basis of atherosclerosis, decreased contractive power of cardiac muscle and decreased cardiac output. These conduced to decreased cerebral perfusion and occurrence of cerebral watershed infarction. Conclusions Because decreased cardiac output can conduce to decreased cerebral perfusion, the patients with ischemic heart disease-induced heart failure are apt to combine with watershed infarction.