Clinical Analysis of Multiple Cerebral Infarction Caused by Large Vessel Stenosis
大血管狭窄致多发脑梗死临床分析

摘要

目的 分析大血管狭窄致多发脑梗死的临床症状。方法 选择我院2018年1月-2019年1月收治的120例脑梗死患者，按照脑梗死类别，将其分为观察组与对照组，观察组患者未多发性脑梗死，对照组患者为心源性脑梗死，每组60人。对比两组患者的一般资料，分析两组患者的影像学情况。结果 观察组患者表现为单侧半球多发灶，也可以表现为双侧半球多发灶，其中单侧半球多发灶占比30%，双侧半球多发灶占比40%，另有25%左右的患者表现为前循环和后循环的多发灶。对照组患者单侧半球多发，造占比2%，双侧半球占比3%。另有1%左右的患者表现为前循环多发灶，具有显著差异（P＜0.05）。相比较之下，狭窄血管实际供血区域的MRI情况可以作为大血管狭窄致多发脑梗死患者临床判断的独立危险因素。结论 通过辅助性诊断方法尤其是CT平扫、MRI诊断，正确识别全面的颅内大出血，分析大动脉狭窄造成的供血区域狭窄情况，是判断脑梗死患者的独立危险因素，也是鉴别心源性栓塞的独立危险因素，可以广泛应用在脑梗死患者的临床判断上，以提高诊断的精准程度。

Abstract

Objective To analyze the clinical symptoms of multiple cerebral infarction caused by large vessel stenosis.
Methods 120 patients with cerebral infarction admitted to our hospital from January 2018 to January 2019 were selected and divided into observation group and control group according to the type of cerebral infarction. The patients in the observation group did not have multiple cerebral infarction, and the patients in the control group were Cardiogenic cerebral infarction, 60 people in each group. The general data of the two groups of patients were compared, and the imaging conditions of the two groups of patients were analyzed.
Results The patients in the observation group presented with multiple foci in unilateral hemisphere and also in bilateral hemisphere, among which unilateral hemisphere multiple foci accounted for 30%, bilateral hemisphere multiple foci accounted for 40%, and another 25% or so. The patient presented with multiple foci in the anterior and posterior circulations. The patients in the control group had multiple unilateral hemispheres, accounting for 2% of the angiogenesis, and 3% of the bilateral hemispheres. Another 1% of patients showed multiple lesions in the anterior circulation, with a significant difference (P<0.05). In contrast, MRI of the actual blood supply area of stenotic vessels can be used as an independent risk factor for clinical judgment in patients with multiple cerebral infarction caused by large vessel stenosis.
Conclusion   Through auxiliary diagnostic methods, especially CT plain scan and MRI diagnosis, the correct identification of comprehensive intracranial hemorrhage and the analysis of the stenosis of the blood supply area caused by aortic stenosis are independent risk factors for judging patients with cerebral infarction, and also for differentiating cardioembolism. It can be widely used in the clinical judgment of patients with cerebral infarction to improve the accuracy of diagnosis.