缺血性脑血管病126例脑血管狭窄分布特征  

Distribution features of cerebral artery stenosis in patients with ischemic cerebrovascular diseases

作　　者：秦正良[1] 刘高飞[1] 陈心岭[1] 

机构地区：[1]南京医科大学第三附属医院神经内科,江苏仪征211900

出　　处：《临床荟萃》2008年第22期1612-1614,共3页Clinical Focus

摘　　要：目的分析缺血性脑血管病患者脑动脉狭窄的分布特征。方法收集我院缺血性脑血管病患者156例,所有患者均行颈动脉彩色超声、经颅多普勒超声(TCD)和数字减影血管造影(DSA)检查,狭窄程度按北美症状性颈动脉狭窄试验法(NASCET)测量标准分为5个等级。结果①颅内动脉狭窄61例,颅外动脉狭窄40例,颅内外动脉均见狭窄25例;②126例动脉狭窄患者中,单支狭窄76例(60.3%),多支狭窄50例(39.7%);③动脉狭窄的常见部位依次为:大脑中动脉>颈内动脉颅外段>大脑前动脉>椎动脉起始段>颈内动脉虹吸段>大脑后动脉>椎动脉远端及基底动脉;④DSA示狭窄程度:126例患者189条狭窄血管中,重度狭窄或闭塞52条(27.5%);⑤82/91例(90.1%)脑卒中病灶与血管狭窄的部位相对应。结论缺血性脑血管病患者以颅内血管狭窄为多见,大脑中动脉主干狭窄的发生率最高,其次是颈内动脉颅外段。Objective To analyze the characteristics of distribution of cerebral artery stenosis in patients with ischemic cerebrovascular diseases. Methods A total of 156 patients with ischemic cerebrovascular diseases were collected from the hospital. All patients underwent color ultrasonography of carotid, TCD and DSA. According to NASCET,arteriostenosis was grouped into five grades. Results ①As for incidence of intracranial and extracranial arteriostenosis,61 cases were of intracranial stenosis, 40 cases extracranial stenosis and 25 cases both. ②As for incidence of single or dual stenosis, among 126 patients with arteriostenosis, single stenosis amounted to 76 cases （60.3 %） and dual to 50 cases （39.7 %）. ③Stenosis occurred in middle cerebral artery, extracranial part of internal carotid artery, anterior cerebral artery, onset part of vertebral artery, siphon part of internal carotid artery, posterior cerebral artery and distal vertebral artery, basilar artery in an order of decreased frequency. ④DSA analysis revealed that,among 189 narrow blood vessels of 126 patients, 52 vessels were shown as severe stenosis or obstruction, accounting for 27. 5%. ⑤Among 91 cases, infarction occurred in the corresponding stenostic vessel in 89. patients, accounting for 90.1% （82/91 cases）. Conclusion Intracranial arteriostenosis is most common in ischemic cerebrovascular diseases. The frequency of stenosis in middle cerebral artery is the highest,extracranial part of internal carotid artery is the next.

关 键 词：脑缺血 动脉粥样硬化 血管造影术 数字减影 

分 类 号：R743[医药卫生—神经病学与精神病学]