缺血性脑血管病患者数字减影血管造影回顾分析  

Digital subtraction angiography in patients with ischemic cerebrovascular disease

作　　者：胡晨[1] 张立群[1] 薛蓉[1] 邹明[1] 廖张元[1] 张天林[1] 

机构地区：[1]天津医科大学总医院神经内科,300052

出　　处：《中华老年心脑血管病杂志》2013年第6期617-619,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨缺血性脑血管病患者颅内外动脉狭窄或闭塞的分布特征及侧支循环开放情况。方法收集166例数字减影血管造影检查确诊为颅内外动脉狭窄或闭塞的缺血性脑血管病患者的临床资料,按年龄分为青年组11例、中年组67例和老年组88例,记录其动脉狭窄及侧支循环开放情况。结果 166例患者中,30.1%有颅内病变,39.8%有颅外病变,30.1%颅内外病变并存;颅外动脉狭窄或闭塞以颈内动脉居多,颅内动脉狭窄或闭塞以大脑中动脉最明显;与青年组比较,中年组、老年组颅内动脉狭窄率明显降低(P<0.01),颅内外动脉狭窄并存比例明显升高(P<0.05)。61例颅内外动脉重度狭窄或闭塞患者存在侧支循环,其中颈内动脉狭窄或闭塞代偿形式以初级侧支循环开放为主,占67.7%,大脑中动脉以次级侧支循环开放为主,占72.2%。结论随着年龄的增长,颅外动脉病变的比例逐渐增高。颅内外大动脉严重狭窄或闭塞时存在3级侧支循环的开放。Objective To study the distribution characteristics and collateral circulation of intracra- nial artery stenosis or occlusion in ischemic cerebrovascular disease patients. Methods One hun- dred and sixty-six patients with digital subtraction angiography-confirmed ischemic cerebrovascu- lar disease were divided into young age group （n= 11）,middle age group （n=67） and old age group （n=88）. Their artery stenosis and collateral circulation were recorded. Results The inci- dence of intracranial artery stenosis, extracranial artery stenosis,intra-and extra-cranial artery ste- nosis was 30.1 %,39.8 %, and 30.1 %, respectively. The extracranial artery stenosis or occlusion was usually found in internal carotid artery whereas the intracranial artery stenosis or occlusion was frequently observed in middle cerebral artery. The incidence of intracranial artery stenosis was significantly lower and that of intra- and extra-cranial artery stenosis was significantly higher in middle and old age groups than in young age group （P〈0.05 ,P〈0. 01）. The collateral circula- tion occurred in 61 patients with severe intra and extra cranial artery stenosis or occlusion and primary collateral circulation accounted for 67.7% and with secondary middle cerebral artery ste- nosis or occlusion accounted for 72.20% （P〈0.05）. Conclusion The incidence of extracranial ar- tery stenosis increases with age. Primary, secondary and tertiary collateral circulation can be found in patients with severe intra-and extra-cranial conducting artery stenosis or occlusion.

关 键 词：脑缺血 血管造影术 数字减影 脑血管障碍 侧支循环 颈动脉狭窄 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]