前循环急性多发脑梗死危险因素及病因分析

目的:了解前循环急性多发脑梗死(AMBI)发病危险因素及病因分析.方法:连续收入73例前循环AMBI患者为试验组,随机收集73例同期入院的前循环急性单发脑梗死(ASBI)患者为对照组.对可能影响AMBI发病的14个危险因素分别进行单因素分析及多元Logistic逐步回归分析.病因分型采用改良TOAST分型方法.结果:AMBI组与ASBI组相比,高血压病、糖尿病、心房颤动、吸烟、年龄及入院时收缩压等危险因素两组间差异有统计学意义.Logistic回归分析显示,年龄(OR=1.03,95%CI:1.01~1.13)、高血压(OR=2.78,95%CI:1.06~7.58)、心房颤动(OR=3.19,95%CI:1.13~9.07)为AMBI发病独立危险因素.与ASBI患者相比,48例一侧半球AMBI患者,动脉粥样硬化血栓形成是其主要病因(P=0.03); 25例双侧半球AMBI患者,心源性栓塞是其主要病因(P=0.01).结论:年龄,高血压病、心房颤动为AMBI发病独立危险因素.动脉粥样硬化血栓形成是一侧半球AMBI患者主要病因;心源性栓塞是双侧半球AMBI患者主要病因.

Analysis of Risk Factors and Etiologic Patterns of Acute Multiple Brain Infarcts(AMBI)in the Anterior Circulation

Aim： To investigate the risk factors and etiologic patterns of acute multiple brain infarcts（AMBI） in the anterior circulation.Methods： 73 consecutive AMBI patients who underwent DWI within 7 days of stroke onset were studied.73 patients with acute single brain infarcts（ASBI） in the anterior circulation were randomly collected as the control during the same period.The single variable analyses of 14 factors that may be related to the onset of AMBI were conducted,and then a logistic multiple regression analysis was performed.Stroke mechanism was determined according to a new subtype classification of ischemic stroke based on treatment and etiologic mechanism.Results： There are significant statistical differences in hypertension,diabetes,atrial fibrillation,smoking,age and systolic blood pressure at admission between the AMBI group and the ASBI group.The logistic regression analyses showed that factors of age（OR=1.03,95%CI：1.01-1.13）,hypertension（OR=2.78,95%CI：1.06-7.58）,atrial fibrillation（OR=3.19,95%CI：1.13-9.07） were independent risk factors for AMBI.48 patients had AMBI in the unilateral hemisphere,and the most frequent cause of stroke was large-artery atherosclerosis（P=0.03）.25 patients had AMBI in the bilateral hemisphere,and the most frequent cause of stroke was cardioembolism（P=0.01）.Conclusion： Age,hypertension,atrial fibrillation were independent risk factors for AMBI.The most frequent cause of AMBI in the unilateral hemisphere was large-artery atherosclerosis.The most frequent cause of AMBI in the bilateral hemisphere was cardioembolism.