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目的探讨老年腔隙性脑梗死的类型与临床特征。方法对以腔隙性脑梗死就诊的老年患者117例回顾分析。结果经做头部CT或核磁共振成像、脑血管多普勒超声并结合临床资料诊断:纯运动性轻偏瘫71例,纯感觉性卒中29例,共济失调性轻瘫7例,构音障碍-手笨拙综合征6例,感觉运动性卒中4例。全部做低密度脂蛋白胆固醇、超敏C-反应蛋白、幽门螺旋杆菌、同型半胱氨酸,其阳性率依次为83.0%、96.6%、68.4%、75.2%。结论老年腔隙性脑梗死病因复杂,临床类型多样,应详细询问病史及查体,系统性做相关辅助检查,综合分析后确定诊断。
Objective To investigate the types and clinical features of elderly patients with lacunar infarction. Methods Retrospective analysis of 117 elderly patients with lacunar infarction. Results of head CT or MRI, cerebrovascular Doppler ultrasound combined with clinical data diagnosis: pure motor hemiparesis in 71 cases, pure sensory stroke in 29 cases, ataxia paresis in 7 cases, dysarthria 6 cases of clumsy hand syndrome, sensory stroke in 4 cases. All of them made low-density lipoprotein cholesterol, high-sensitivity C-reactive protein, Helicobacter pylori and homocysteine. The positive rates were 83.0%, 96.6%, 68.4% and 75.2%, respectively. Conclusions The causes of lacunar infarction in elderly patients are complex and have various clinical types. Patients should be asked about their medical history and physical examination in detail, and the related auxiliary examinations should be done systematically to confirm the diagnosis after comprehensive analysis.