天津医药

天津医药 ›› 2016, Vol. 44 ›› Issue (3): 363-366.doi: 10.11958/20150054

• 临床研究 • 上一篇    下一篇

微栓子监测在脑干梗死和椎基底动脉狭窄中的作用

荣艳红,赵琨,苏红军， 齐金龙   

  1. 天津市宝坻区人民医院神经内科
  • 收稿日期:2015-07-20 修回日期:2015-11-27 出版日期:2016-03-15 发布日期:2016-03-15
  • 通讯作者: 赵琨 E-mail:bdzhanghui2004@163.com
  • 作者简介:荣艳红（1979）， 女， 硕士， 主要从事脑血管病的研究

Monitoring microembolic signals in patients with brain stem infarction

RONG Yanhong, ZHAO Kun△, SU Hongjun, QI Jinlong   

  1. Neurology Department, Baodi People′s Hospital, Tianjin 301800, China
  • Received:2015-07-20 Revised:2015-11-27 Published:2016-03-15 Online:2016-03-15
  • Contact: ZHAO Kun E-mail:bdzhanghui2004@163.com

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摘要： 摘要 目的：目前有关脑干梗死的微栓子监测未见报道，探讨脑干梗死患者微栓子阳性与椎基底动脉狭窄的关系。方法：156例急性脑干梗死的患者，发病7天内应用经颅多普勒经枕窗进行基底动脉微栓子监测。结果：20例(12.8%) 患者出现MES，MES阳性组与阴性组临床特点、实验室数据无统计学差异；颅内椎基底动脉狭窄为MES阳性的独立危险因素(odds ratio, 9.73; 95% confidence interval, 1.34-81.46;P=0.038)，其中重度椎基底动脉狭窄MES阳性率较中度狭窄升高(odds ratio, 9.76; 95% confidence interval, 1.53-80.12;P=0.040)；86例病人伴有椎基底动脉狭窄，微栓子阳性组较阴性组脑梗死病灶增多（P=0.014)。结论：椎基底动脉狭窄是急性脑干梗死微栓子的主要来源，椎基底动脉狭窄患者的微栓子是多部位脑梗死的病因。

关键词: 关键词：脑干梗死, 椎基底动脉, 微栓子, 经颅多普勒超声

Abstract: Background: Monitoring microembolic signals (MES) in patients with brain stem infarction has not been reported in the literature. This study aimed to investigate the relation between the presence of MES and vertebrobasilar artery (VBA) stenosis. Methods: The study included 156 patients with acute brain stem infarction who underwent detection of MES at the VBA through the occipital window using transcranial Doppler (TCD) ultrasonography. Results: MES were present in 20 (12.8%) patients. Clinical characteristics and laboratory parameters of the MES-positive and MES-negative groups did not differ significantly. Intracranial VBA stenosis was found to be an independent risk factor for MES [odds ratio (OR), 9.73; 95% confidence interval (CI), 1.34–81.46; p=0.038]. Patients with severe VBA stenosis had a higher prevalence of MES than those with moderate VBA stenosis (OR, 9.76; 95% CI, 1.53-80.12; p=0.040). VBA stenosis was found in 86 patients. The MES-positive group had more infarctions than the MES-negative group (p=0.014). Conclusion: VBA stenosis is the primary source of microemboli in patients with acute brain stem infarction. Microemboli originating from VBA stenosis are the cause of multiple infarctions.

Key words: Keywords: Brain stem infarction, vertebrobasilar stenosis, microembolic signal, transcranial Doppler ultrasonography