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目的探讨儿童动脉缺血性卒中(AIS)的起病方式、梗死部位与卒中病因的关系。方法回顾性分析1997年1月-2007年10月在武汉市儿童医院及华中科技大学同济医学院附属同济医院儿科住院、经头颅影像学证实并诊断为AIS的病例97例。年龄6个月～18岁。按病因分为炎性反应性动脉病组(32例)与非炎性反应性动脉病组(65例)(脑血管畸形、心源性栓塞、血液系统疾病及代谢疾病)。记录二组患儿年龄、起病方式及梗死部位,并将起病方式分为急性与非急性,梗死部位分为基底核区与大脑中动脉主干供血区。采用t检验比较二组AIS患儿平均年龄差异,χ2检验比较二组患儿起病方式与梗死部位差异。结果炎性反应性动脉病组与非炎性反应性动脉病组平均年龄比较差异无统计学意义(t=1.573P>0.05)。炎性反应性动脉病组中急性起病者10例(31.2%),非炎性反应性动脉病组中急性起病者38例(58.5%),二组比较差异有统计学意义(χ2=6.352P<0.05)。炎性反应性动脉病组梗死灶位于基底核区21例(65.6%),非炎性反应性动脉病组梗死灶位于基底核区28例(43.1%),二组比较差异有统计学意义(χ2=4.361P<0.05)。结论起病方式与梗死部位可以提示儿童AIS的病因诊断。非急性起病、梗死灶位于基底核区的AIS,其病因多为炎性反应性动脉病。
Objective To investigate the onset of arterial ischemic stroke (AIS) in children and the relationship between the infarct location and the cause of stroke. Methods A retrospective analysis of 97 cases of pediatric hospitalized in Tongji Hospital Affiliated to Tongji Medical College of Wuhan University from January 1997 to October 2007 was confirmed by head imaging and diagnosed as AIS. Aged 6 months to 18 years old. Etiology was divided into inflammatory reactive arterial disease group (32 cases) and non-inflammatory reactive arterial disease group (65 cases) (cerebrovascular malformations, cardiac embolism, blood system diseases and metabolic diseases). Two groups of children were recorded age, onset and infarction, and the onset is divided into acute and non-acute, infarction is divided into basal ganglia and middle cerebral artery artery blood supply area. The t-test was used to compare the average age difference between the two groups of AIS children, χ2 test compared the onset of the two groups of children and infarct differences. Results There was no significant difference in mean age between inflammatory reactive arterial disease group and non-inflammatory reactive arterial disease group (t = 1.573P> 0.05). There were 10 acute onset patients (31.2%) in the group of inflammatory reactive arteriopathy and 38 (58.5%) acute onset patients in the non-inflammatory reactive arterial disease group, the difference was statistically significant (χ2 = 6.352P <0.05). There were 21 cases (65.6%) of infarction in inflammatory reactive arterial disease group and 28 cases (43.1%) in non-inflammatory reactive arterial disease group in infarction area of basal ganglia, the differences between the two groups were statistically significant ( χ2 = 4.361P <0.05). Conclusion The onset of disease and infarction may be the etiological diagnosis of AIS in children. Non-acute onset, infarction in the basal ganglia AIS, the etiology of mostly inflammatory reactive arterial disease.