203例急性脑梗死患者脑供血动脉分布特点与分析  

Distribution Characteristics and Analysis of Cerebral Artery in 203 Cases of Patients with Acute Cerebral Infarction

作　　者：李怡[1] 王振海[2] 马斌武[2] 

机构地区：[1]宁夏医科大学,宁夏银川750004 [2]宁夏医科大学总医院,宁夏银川750004

出　　处：《中风与神经疾病杂志》2014年第3期240-243,共4页Journal of Apoplexy and Nervous Diseases

摘　　要：目的运用数字减影血管造影(Digital subtraction angiography DSA)技术,探讨急性脑梗死患者脑供血动脉狭窄的特点及侧枝循环代偿情况。方法回顾性分析203例急性脑梗死患者的DSA检查结果,明确脑供血动脉狭窄发生率、狭窄部位、程度及侧枝循环建立情况。结果 203例患者中发现单纯颅内动脉狭窄78例(43.09%),单纯颅外动脉狭窄46例(25.41%),颅内、颅外动脉均存在狭窄者57例(31.49%)。198处颅内动脉狭窄中,大脑中动脉狭窄72处(36.55%);214处颅外动脉狭窄中,颈内动脉颅外段狭窄77处(35.98%),椎动脉颅外段狭窄71处(33.18%)。分析可能引起同一侧枝循环途径的病变共174处,发现侧枝循环118例,Willis环代偿所占比例较高,其次为软脑膜吻合支。重度狭窄及闭塞组侧枝循环代偿发生率明显高于轻、中度狭窄组(P<0.05)。结论急性脑梗死患者颅内动脉狭窄发生率高于颅外,颅内动脉狭窄好发于大脑中动脉,颅外动脉狭窄好发于颈内动脉颅外段及椎动脉颅外段。侧枝循环途径以Willis环最常见,软脑膜吻合支次之,严重的脑供血动脉狭窄更易发生侧枝循环代偿。Objective The present study aims to explore the characteristics of cerebral artery stenosis and compen- satory efl＇eet of collateral circulation in patients with acute cerebral infarction using digital subtraction angiography （ DSA ） technology. Methods We performed a retrospective analysis on DSA results of 203 cases of patients with acute cerebral infarction,in order to determine the incidence rate of cerebral artery stenosis, the position and degree of stenosis, as well as the establishment situation of collateral circulation. Results Among 203 cases of patients,there were 78 cases （43.09%） of patients with simple intracranial arterial stenosis,46 cases （25.41%） of patients with simple extracranial artery stenosis, and 57 cases （31.49%） of intracranial and extracranial artery stenosis. Among 198 cases of intracranial arterial stenosis, there were 72 cases （36.55%） of middle cerebral artery stenosis, among 214 cases of extracranial artery stenosis, there were 77 cases （35.98%） of extracranial internal carotid artery stenosis and 71 cases （33.18%） of extracranial vertebral artery stenosis. A total of 174 lesions were deduced to cause the same collateral circulation pathway, and 118 cases of col- lateral circulation were found. The compensation of Willis ring accounted for a higher proportion, followed by the leptomen- ingeal anastomosis. The incidence rate of compensatory collateral circulation in the severe stenosis and occlusion group was significantly higher than the mild and moderate stenosis groups （ P 〈 0.05 ）. Conclusion The incidence rate of intracrani- al arterial stenosis was higher than that of extracranial arterial stenosis in patients with acute cerebral infarction. The in- tracranial arterial stenosis was often occurred in the middle cerebral artery, while the extracranial artery stenosis was often occurred in the extracranial internal carotid artery and extracranial vertebral artery. The collateral circulation approach was mostly common in the circle of Willis,

关 键 词：脑梗死 动脉狭窄 侧枝循环 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] R815[医药卫生—临床医学]