皮质型分水岭脑梗死与颈动脉狭窄的关系及支架置入术后的随访对照研究  

Relationship between cortical watershed infarction and and control study on prognosis after stent insertion

作　　者：郭富强[1] 吴文斌[1] 张天[2] 余能伟[1] 孙祥荣[1] 杨友松[1] 孙红斌[1] 肖军[1] 董凌琳[1] 曾宪容[1] 代红源[1] 

机构地区：[1]四川省人民医院神经内科,成都610072 [2]四川省人民医院放射科

出　　处：《中华神经医学杂志》2008年第9期935-938,共4页Chinese Journal of Neuromedicine

摘　　要：目的 探讨戍质型分水岭脑梗死与颈动脉狭窄的芙系及支架置入术的治疗效果：方法23例绎MRI或CT确诊的皮质型分水岭脑梗死患者全部行DSA检查：对符合手术指征的11例患者行颈动脉支架置入术（支架组），另12例接受常规治疗（保守组）；全部患者随访6～12月：结果23例皮质型分水岭脯梗死患者除1例无动脉狭窄外．其余均有不同稃度颈动脉狭窄．且动脉狭窄程度与临床症状和“盗血”现象的出现存在一定关系（P〈0．05）：支架组术后即刻动脉狭窄改善90％以上，头晕症状和“盗血”现象消失：随访6～12月后，支架组新增的临床症状、“盗血”和动脉狭窄明显少于保守组，差异有统计学意义（P〈0．05）结论 皮质型分水岭脑梗死的发生与颈动脉狭窄存在一定关系；支架置入术对颈动脉狭窄的改善及皮质型分水岭脑梗死的预防有一定临床价值。Objective To investigate the relationship between cortical watershed infarction and carotid artery stenosis and evaluate the stent insertion operation. Methods After 23 cortical watershed infarction patients diagnosed by CT or MRI received DSA detection, we performed stent insertion operation on 11 patients according to their requirements, and conservative treatment on the remaining 12 patients. All the patients underwent follow up for 6-12 months post-operatively. Results Among the 23 cortical watershed infarction patients, 22 were detected with carotid artery stenosis. Statistical analysis showed that the degree of carotid artery stenosis was associated with the clinical symptoms and the volume of steal phenomenon （P〈0.05）; further, the artery stenosis improvement was over 90% with the stent inserted; conversely, dizziness and steal phenomenon disappeared. The post procedure follow-up, ranging 6-12 months, showed that the patients with stent insertion got less new symptoms, steal phenomenon and artery stenosis, compared with the patients with conservation treatment （P〈0.05）. Conclusion Cortical watershed infarction is associated with carotid artery stenosis. The stent insertion is useful for the treatment of carotid artery stenosis and prevention of cortical watershed infarction.

关 键 词：分水岭脑梗死 颈动脉狭窄 支架置入 随访对照研究 

分 类 号：R743.33[医药卫生—神经病学与精神病学]