心源性脑栓塞100例临床分析.docVIP

心源性脑栓塞100例临床分析[摘要] 目的：分析心源性脑栓塞（cardiogenic cerebral embolism，CCE）的病因及影像学特点。方法：对100例心源性脑栓塞患者既往史、临床表现、心电图、超声心动图、CT、MRI进行分析。结果：心房纤颤84例，占84%；风湿性心脏瓣膜病伴心房纤颤21例，占21%；非风湿性心脏瓣膜病伴心房纤颤63例，占63%；头颅磁共振检查提示大面积脑梗死76例占76%，合并出血性梗死23例，占23%。结论：心房纤颤是引起心源性脑栓塞的最常见原因，其中大多数为非瓣膜病性心房纤颤，心源性脑栓塞约76%为大面积梗死，而且病灶累及多叶，易发生出血性梗死。 [关键词] 心源性脑栓塞；心房纤颤；出血性梗死；电子计算机体层扫描；磁共振成像；超声心动图 [中图分类号] R743.33 [文献标识码]Ａ [文章编号]1673-7210（2011）03（c）-044-03 Clinical analysis of 100 cardiogenic cerebral embolism patients WANG Zhizhong, LI Honghua*, WU Qiang, WU Fei, XU Zhipeng, LIN Lang, YANG Mei Department of Neurology, Wuhan General Hospital, Guangzhou Command, PLA, Wuhan 430070, China [Abstract] Objective: To analyze the mechanism and the clinical imaging features of cardiogenic cerebral embolism (CCE). Methods: We retrospectively reviewed the records of 100 CCE patients who had undergone ECG, echocardiogram, computetized tomography (CT) and magnetic resonance imaging (MRI) evaluation. Results: Among 100 CCE patients, eighty four percent patients had atrial fibrillation, and Vulvular-atrial fibrillation account for sixty three percent, seventy six percent patients magnetic resonance imaging (MRI) demonstrate large area infraction, twenty three percent patients appear hemorrhagic infraction. Conclusion: Atrial fibrillation is the most common cause of CCE. Non-vulvular-atrial fibrillation more common, seventy six percent CCE patients magnetic resonance imaging demonstrate large area infarction, and CCE patients is prone to hemorrhagic infarction (HI). [Key words] Cardiogenic cerebral embolism (CCE); Atrial fibrillation; Hemorrhagic infarction (HI); Computetized tomography (CT); Magnetic resonance imaging (MRI); Echocardiogram [作者简介] 汪志忠（1984.2-），男，硕士研究生。 [通讯作者] 黎红华（1965.9-），女， 博士，主任医师，硕士研究生导师，主要从事脑血管病与神经肌肉疾病研究，现为广州军区武汉总医院神经内科主任。 心源性脑栓塞（cardiogenic cerebral embolism， CCE）约占缺血性脑卒中的15%,心源性脑栓塞患者大多病情重且易发生再次栓塞，致残率及致死率高。其诊断主要根据临床发病特点，大部分患者很难找到栓子证据。心电图、超声心动图、头颅CT及磁共振可协助临床诊断[1]。因此早期明确诊断，及时采取有力措施干预病情发展，防止复