颅内外动脉重度狭窄或闭塞患者的侧支循环途径  

Collateral circulation pathways in patients with severe intra-and extra-cranial artery stenosis or occlusion

作　　者：范秀玉[1] 王琳娜[1] 范博[1] 吴铁丽[1] 

机构地区：[1]齐齐哈尔医学院附属第三医院电生理科,161000

出　　处：《中华老年心脑血管病杂志》2012年第7期725-727,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨颅内外动脉重度狭窄或闭塞患者的侧支循环途径。方法对100例老年颅内外动脉重度狭窄或闭塞患者,采用经颅多普勒超声(TCD)技术评估侧支循环变化。结果大脑中动脉主干重度狭窄或闭塞59例,TCD显示软脑膜吻合侧支通路开放34例,占57.6%。颈内动脉起始部重度狭窄或闭塞30例,侧支通路开放24例,占80.0%,其中前动脉交通侧支开放8例,后动脉交通侧支开放2例,前动脉交通与后动脉交通侧支同时开放4例,眼动脉侧支开放6例,前动脉交通、后动脉交通和眼动脉侧支同时开放4例。锁骨下动脉重度狭窄7例,TCD发现窃血改变4例,占57.1%。椎动脉重度狭窄或闭塞3例中,2例椎动脉起始部闭塞患者出现颈外动脉-椎动脉侧支开放。左侧颈总动脉闭塞伴头臂干中度狭窄1例,TCD显示椎动脉-颈外动脉-颈内动脉侧支通路开放。结论 TCD技术有助于了解颅内外动脉重度狭窄或闭塞患者的侧支循环途径。Objective To study the collateral circulation pathways in patients with severe intra-and extra-cranial artery stenosis or occlusion. Methods Collateral circulation change was assessed by TCD in 100 patients with severe intra-and extra-cranial artery stenosis or occlusion. Results TCD showed piamatral anastomosis of the open collateral circulation pathways in 34（57.6 %）out of the 59 patients with severe stenosis or occlusion of the main cerebral middle artery. Among the 30 pa- tients with severe initial internal carotid artery portion stenosis or occlusion,open collateral circu- lation pathways were found in 24（80.0 %） ,including anterior communicating artery collateral cir- culation pathway in 8, posterior communicating artery collateral circulation pathway in 2, simulta- neous anterior and posterior communicating artery collateral circulation pathway in 4, ophthalmic artery collateral circulation pathway in 6, simultaneous anterior and posterior communicating ar- tery and ophthalmic artery collateral circulation pathway in 4. In addition,TCD showed the steal waveform in 4（57.1%） of the 7 patients with severe subclavian artery stenosis,including proxi- mal vertebral artery occlusion in 3, open external carotid collateral circulation pathway-vertebral artery circulation pathway in 2 with the initial vertebral artery portion occlusion,left common ca- rotid artery occlusion accompanying moderate brachiocephalic trunk stenosis in 1. The sequence of collateral circulation pathways was open vertebral artery-external carotid artery-internal carotid artery collateral circulation pathways. Conclusion TCD contributes to the understanding of col- lateral circulation pathways in patients with severe intra-and extra-cranial artery stenosis or occlu- sion.

关 键 词：颅内动脉疾病 颈动脉狭窄 侧支循环 超声检查 多普勒 经颅 脑缺血 

分 类 号：R743[医药卫生—神经病学与精神病学]