临床的完全前循环脑梗死可以预测出超早期卒中的DSA表现  

Clinical TACI may predict DSA findings in hyperacute stroke

作　　者：徐蔚海[1] 黄一宁[1] 金征宇[2] 高山[1] 张青[1] 崔丽英[1] 李舜伟[1] 

机构地区：[1]中国医学科学院中国协和医科大学,北京协和医院神经科,北京100730 [2]中国医学科学院中国协和医科大学,北京协和医院放射科,北京100730

出　　处：《国际内科双语杂志（中英文）》2005年第11期66-70,共5页

摘　　要：我们对27例发病在6小时内的超早期卒中患者进行了临床分型和血管造影检查，并将二者的结果进行比较。完全前循环脑梗死的K值为0．82，提示较好的一致性。源于大血管闭塞的临床完全前循环脑梗死可以用来预测超早期卒中的血管造影表现。如果有大型的研究证实这一结果，未来溶栓试验的入选标准有可能得到优化。BACKGROUND AND PURPOSE： Total anterior circulation infarcts（TACI） were considered to result from occlusion of the main stem internal cerebral artery （ICA） or middle cerebral artery （MCA）. The rate of reeanalization of major arterial occlusions with IV rt PA is low, while interventional thrombolysis or combined intravenous and intraarterial thrombolysis were promising in that patient group. The aim of this study was to examine how closely the clinical subtypes of TACI correlate to the underlying pathophysiology within 6 hours from stroke onset. METHODS： Totally 27 consecutive patients with hyperacute ischemic stroke（HIS）participated in the study. Clineial classification and digital substraction angiography（DSA）were performed on each patient within 6 hours from stroke onset and their results were compared with each other. RESULTS： Of the 8 cases with clinical TACI, 1 with ICA stenosis （actual probable partial anterior circulation infarcts, PACI）was mis- classified. One patient with ICA occlusion was misdiagnosed as PACI. The K and positive predictive value/negative predictive value of TACI were 0.82 and 87.5%/94. 7%. CONCLUSIONS： The clinical subtypes of TACI can excellently predict angiographic findings in HIS, which may contribute to the patients selection for more agressive thrombolysis treatment.

关 键 词：临床分型 卒中患者 超早期 脑梗死 前循环 DSA表现 预测 血管造影检查 血管造影表现 

分 类 号：R683.42[医药卫生—骨科学] R743[医药卫生—外科学]