열공성 뇌경색과 영역성 뇌경색의 위험인자에 대한 비교

Abstract

Background and purpose : Lacunar infarction (LI) is an ischemic stroke subtype with unique clinical, radiological and pathological features, but its pathogenesis remains unsettled. For a better understanding the underlying pathophysiological process of LI, the prevalence of risk factors in patients with LI was compared with those in patients with territorial infarcts. Methods : We studied the risk factor profiles of a series of 104 consecutive patients with a first-ever lacunar infarct, and 104 age- and sex-matched patients with a first-ever carotid artery-distribution area infarct involving the cortex registered at Chonnam University Hospital stroke registry from January 1996 to June 1998. The following risk factors were evaluated: hypertension, lipid profile, heart disease, diabetes, alcohol drinking, and cigarette smoking. Results : Among these risk factors, hypertension was more prevalent (p = 0.038) and heart disease was less prevalent (p = 0.001) in the lacunar group than in the territorial group. Taking into consideration of the prevalence of hypertension between lacunar infarct and thrombotic or embolic type territorial infarct, statistical significance was not found in thrombotic type(p = 0.5127), but in embolic type territorial infarct(p = 0.0027). The lipid profile, diabetes, alcohol drinking, and cigarette smoking had no statistical significance. Conclusions : Those results suggest that, on the contrary to previous knowledge, hypertension is no more important risk factor in the development of lacunar infarction than it is in the development of other types of ischemic stroke that are presumed to be due to atherosclerosis in a major cerebral artery. Thus hypertension itself is not regarded as a unique pathophysiological mechanism for lacunar stroke among all the other types of ischemic strokes. Korean Journal of Stroke 1999;1(1):35~41