神经损伤与功能重建2025，Vol.20Issue(2)：67-72,6.DOI:10.16780/j.cnki.sjssgncj.20241242
脑桥旁正中穿支动脉粥样硬化病临床特点分析
Analysis of Clinical Features of Paramedian Pontine Branch Atheromatous Disease
张海廷 1王维 1郭海晓 1周红 1张瑞云 1李佳平1
作者信息
摘要
Abstract
Objective:To explore the clinical characteristics of cerebral infarction caused by paramedian pontine arteries(PPA)branch atheromatous disease(BAD)-PPA-BAD.Methods:A retrospective analysis was conducted on 221 patients diagnosed with PPA-BAD in the Department of Neurology,Civil Aviation General Hospital from 2018 to 2024.According to the presence or absence of progressive motor deficits,patients were divided into a progressive group(140 cases)and a control group(81 cases);based on prognosis,they were classified into a good prognosis group(163 cases)and a poor prognosis group(58 cases);depending on whether they received recombinant tissue plasminogen activator(rt-PA)thrombolytic therapy,they were divided into a treatment group(14 cases)and a control group(207 cases);for patients in the progressive group,based on whether tirofiban was used,they were divided into a tirofiban treatment group(42 cases)and a control group(98 cases).Demographic,clinical,and imaging data of each group were compared,and the effects of rt-PA intravenous thrombolysis and tirofiban treatment were explored.Results:(1)140 cases(63.3％)progressed after 6 hours of onset,indicating that PPA-BAD tends to easily progress and worsen;the proportion of patients with hyperlipidemia and those presenting with hemiplegia symptoms was higher in the progressive group,and the NIHSS scores at onset,peak,and discharge were higher(all P＜0.05);the prognosis of the progressive group was worse than that of the control group(P＜0.05).(2)Logistic multivariate analysis indicated that advanced age,history of old cerebral infarction,occurrence of progressive motor deficits,and large infarct size suggested a poor prognosis(all P＜0.05);clinical manifestations accompanied by dizziness and ataxia tended to show a trend of good prognosis(P＜0.05).(3)rt-PA intravenous thrombolysis and tirofiban were safe;there was no statistically significant difference in prognosis between the medication group and the control group(P＞0.05).Conclusion:Patients with PPA-BAD are prone to developing progressive motor deficits;factors such as advanced age,history of old cerebral infarction,occurrence of progressive motor deficits,and large infarct size can lead to poor prognosis;currently,there is a lack of effective clinical predictive indicators,necessitating comprehensive individualized treatment;the application of rt-PA intravenous thrombolysis and tirofiban is recommended to improve therapeutic efficacy.关键词
穿支动脉粥样硬化性病/脑桥旁正中动脉/静脉溶栓/替罗非班Key words
paramedian pontine arteries/branch atheromatous disease/intravenous thrombolysis/tirofiban分类
临床医学引用本文复制引用
张海廷,王维,郭海晓,周红,张瑞云,李佳平..脑桥旁正中穿支动脉粥样硬化病临床特点分析[J].神经损伤与功能重建,2025,20(2):67-72,6.
