摘要
目的 研究大面积脑梗死患者的病因及脑动脉病理变化的程度。方法 对５８ 例脑梗死及２０ 例对照死亡病例的脑底中型动脉及一级分支动脉、脑内小动脉、微动脉进行了病理观察和形态定量分析。结果 （１） 脑栓塞占３３／５８ 例，脑血栓形成占１１／５８ 例，原因不明的脑梗死１４ 例；（２） 脑梗死组颅内各级动脉的面积比值（４１ ±１５） ％ 比对照组的（６０ ±１０） ％ 明显减小（ Ｐ＜ ０ ．０１） ；（３） 脑栓塞组双侧大脑中动脉主干（ Ｍ１ 段） 远端口径狭窄度（６２ ±１９） ％ ，椎基底动脉为（５２ ±２４） ％ 与脑血栓形成组的（７５ ±１６） 及（７８ ±１０） ％ 比较，差异有非常显著意义（ Ｐ＜ ０ ．０５ ， Ｐ＜ ０ ．０１） ，脑血栓形成组大脑中动脉 Ｍ１ 段近端口径狭窄度（６８ ±１５） ％ 与脑栓塞组（６２ ±２２） ％ 比较，差异无显著意义（ Ｐ＞ ０ ．０５） 。结论 大面积脑梗死主要的病变部位在脑底中型动脉及一级分支动脉，脑底多条动脉严重动脉粥样硬化导致动脉管腔的中、重度狭窄或在此基础上的栓塞，栓子机化、再通或血栓形成是中老年人大面积脑梗死的重要病理基础。
Objective To investigate the cause and severity of intracranial arterial lesions in extensive cerebral infarction (CI). Methods 78 consecutive autopsy cases were studied. They included 58 cases of CI and 20 cases of other diseases as control. Medium sized intracranial arteries and their main branches, small intracerebral arteries, and arterioles were examined with light microscopy. Quantitative analysis was made with computer. Results CI due to embolism was seen in 33/58 (56.9%) cases, thrombosis in 11/58 (19%), and unknown etiology in 14/58 (24.1%). The mean LA VA ratios of the medium sized intracranial arteries and their main branches, small intracerebral arteries and arterioles were lower in the CI patients than in the controls ( P <0 01). Atherosclerotic narrowing of the distal part of M 1 segment of both lateral cerebral middle arteries, the basilar arteries and the main branches in the patients with thrombosis was markedly more severe than in those with embolism ( P<0.05, P<0.01) . Conclusion Patients with CI have arterial lesions of different levels but the principal portions of cerebral artery lesions are the medium sized intracranial arteries and their main branches. Thrombosis and embolism with medium, severe atherosclerotic narrowing of several arteries may play an important role in causing extensive CI in the middle aged and the elderly.
出处
《中华医学杂志》
CAS
CSCD
北大核心
1999年第8期607-609,共3页
National Medical Journal of China
关键词
脑梗死
脑缺血
脑动脉
病理
Cerebral infarction Cerebral ischemia Cerebral artery Pathology
