Willis动脉环变异与缺血性脑血管病关系的临床探讨  

Relationship between Willis arterial circle abnormality and ischemic cerebrovascular disease

作　　者：马斌武[1] 黄李雅[1] 杜彦辉[1] 陈桂生[1] 李勇军[1] 候晓霖[1] 

机构地区：[1]宁夏医学院附属医院,宁夏银川750004

出　　处：《宁夏医学杂志》2008年第11期967-968,共2页Ningxia Medical Journal

摘　　要：目的探讨Willis动脉环的形态变异与缺血性脑血管病的关系,为临床治疗选择个体化的治疗方案提供依据。方法采用数字减影血管造影技术(DSA)对103例缺血性脑血管病患者行主动脉弓和全脑血管造影,应用A1优势征判断Willis前环的完整性,以大脑后动脉供血类型判断Willis后环的完整性。结果(1)103例病人中A1优势征者41.74%;大脑后动脉供血为基底动脉供血型者58.25%;颈动脉供血型者6.80%;混合供血型者34.95%。(2)共检出血管狭窄76例,临床症状和血管狭窄部位符合者61例(59.22%),Willis环形态变异占78.69%;不符者15例(14.56%),Willis环形态变异占86.67%;无狭窄血管27例(26.21%),Willis环形态变异占66.67%。结论Willis动脉环不完整性与缺血性脑血管病的发病及发病后的血流动力学代偿密切相关;血流动力学的改变可通过侧支循环造成临床症状和血管狭窄部位不符,为临床制定个体化的治疗方案提供依据。Objective To investigate the relationship between Willis arterial circle abnormality and ischemic cerebrovascular disease and to provide anatomical evidences for clinical intervention. Methods Digital subtraction angiography （DSA） technique was used for aortic arch and cranial angiography in 103 patients with ischemic cerebrovascular disease. The integrality of anterior Willis circle was judged by A1 odds, sign and the integrality of posterior Willis circle was judged by blood - supply type of posterior cerebral artery （PCA）. Results （ 1 ） A1 odds sign was found in 41.74% patients, the blood - supply of PCA origining from basilar artery was 58. 25% and carotid artery6.80%. Mixed blood - supply of PCA was 34.95%. （2） 76 patients were found cerebrovascular stenosis, clinical symptoms in 61 patients of them （59.22%）, were significant correlated to the locations of stenosis, Willis arterial circle abnormality was 78.69%, but clinical symptoms in 15 patients （ 14.56% ） were no correlated to the locations of stenosis, willis Arterial Circle abnormality was 86.67%. 27patients were not found with stenosis （26.21%）, Willis arterial circle abnormality was 66.67%. Conclusion Paramorph Willis arterial circle is correlated to ischemic cerebrovascular disease and hemodynamics compensation. The changes of hemodynamics can result in clinical symptom inconsistent with the location of stenosis by collateral circulation.

关 键 词：缺血性脑血管病 WILLIS动脉环 数字减影血管造影 

分 类 号：R743.3[医药卫生—神经病学与精神病学]