内囊预警综合征临床、影像学特征及预后分析

doi:10.3969/j.issn.1673-5765.2019.01.005

摘要/Abstract

摘要：

目的探讨内囊预警综合征的临床特点、影像学特征、病因及预后，提高对该病的认识和诊疗水平。方法收集2015年1月-2017年12月海军军医大学附属长海医院住院治疗的TIA患者中41例内囊预警综合征患者的临床资料、影像学资料，并进行了3个月预后随访。结果 41例患者中高血压病34例（82.9%），高脂血症24例（58.5%），吸烟18例（43.9%），糖尿病 9例（22.0%）。8例（19.5%）为纯感觉障碍，20例（48.8%）纯运动障碍，13例（31.7%）运动和感觉均有障碍。37例（90.2%）患者有责任血管（颈内动脉或MCA）狭窄，11例患者行血管管壁HR-MRI检查，其中10例（90.9%）可见MCA粥样硬化斑块。41例患者中30例（73.2%）予双联抗血小板药物治疗，有 5例（12.2%）患者3个月内进展为脑梗死，9例（22.0%）患者经对因手术治疗后无病情再发。结论内囊预警综合征的主要病因是MCA粥样硬化。双联抗血小板治疗有效。有明确病因及手术指征患者，应尽快手术治疗。

文章导读： 在本研究纳入的41例内囊预警综合征患者中，多数病因为动脉粥样硬化，双联抗血小板治疗和针对病因的手术治疗为临床上的常用治疗措施，效果较好。

关键词: 短暂性脑缺血发作; 内囊预警综合征; 预后

Abstract:

Objective To investigate the etiology, clinical and imaging characteristics, and prognosis in patients with capsular warning syndrome (CWS). Methods A retrospective analysis of data of 41 patients with CWS from Department of Neurology, Changhai hospital, Navy Medical University from January 1, 2015 to December 31, 2017 was performed. Results Of 41 patients with CWS, 34 (82.9%) with hypertension, 24 (58.5%) with hyperlipemia, 18 (43.9%) having smoking, and 9 (22.0%) with diabetes. 20 (48.8%) cases showed pure motor symptoms, 8 (19.5%) cases showed pure sensory symptoms, and 13 (31.7%) cases showed sensorymotor symptoms. 37 (90.2%) patients had culprit artery (internal carotid artery and middle cerebral artery) stenosis, 11 patients underwent high-resolution magnetic resonance imaging examination, and 10 (90.9%) showed cerebral artery plaques. Of 41 patients, 30 (73.2%) were treated with dual antiplatelet drugs, and 5 patients (12.2%) progressed to cerebral infarction within 3 months. Nine patients (22.0%) had no recurrence after endovascular treatment. Conclusions The main cause of capsule warning syndrome is arteriosclerosis of middle cerebral artery. Patients with clear etiology and surgical indication should be treated as soon as possible. Dual antiplatelet therapy is more effective.

Key words: Transient ischemic attack; Capsular warning syndrome; Prognosis

孙旭，刘振宇，范存秀，黎佳思，毕晓莹. 内囊预警综合征临床、影像学特征及预后分析[J]. 中国卒中杂志, 2019, 14(01): 29-32.

SUN Xu, LIU Zhen-Yu, FAN Cun-Xiu, LI Jia-Si, BI Xiao-Ying. Analysis of Clinical, Imaging Characteristics and Prognosis in Patients with Capsular Warning Syndrome[J]. Chinese Journal of Stroke, 2019, 14(01): 29-32.

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