介入治疗大脑中动脉急性闭塞后脑缺血再灌注损伤的影像学观察  

Imaging observation of cerebral ischemia reperfusion injury after interventional therapy in acute middle cerebral artery occlusion

作　　者：易旭[1] 矫树生[1] 刘承春[1] 张志宏[1] 吴娅[1] 李小树[1] 梁春荣[1] 张猛[1] 王延江[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所神经内科,重庆400042

出　　处：《重庆医学》2015年第12期1585-1587,1591,共4页Chongqing medicine

基　　金：国家自然科学基金资助项目(81200988;81000549);国家博士后科学基金资助项目(2012M521861;2013T60955);重庆市科学技术委员会基金资助项目(CSTC2012JJA10111);重庆市博士后基金资助项目(Xm201342)

摘　　要：目的探讨介入治疗大脑中动脉急性闭塞后脑缺血再灌注损伤(CIRI)的影像学变化。方法选择2013年1月至2014年11月该院收治的大脑中动脉急性闭塞患者32例,16例患者进行溶栓和(或)机械取栓后血管再通治疗(再通组),16例患者未进行溶栓治疗(非再通组),对比分析其发病时及第3、7天的头颅影像学变化差异。结果在发病后第3天再通组患者侧脑室受压程度比例、中线移位程度均重于非再通组[0.50±0.11 vs.0.58±0.10,0.57(0.18,0.83)vs.0.22(0,0.57)cm],两组比较差异有统计学意义(P<0.05);在发病后第7天再通组患者侧脑室受压程度比例、中线移位程度均轻于非再通组[0.80±0.11 vs.0.55±0.12,0(0,0.13)vs.0.46(0,0.88)cm],两组比较差异有统计学意义(P<0.05)。结论介入治疗虽是缺血性卒中早期治疗的重要手段,但其加重了早期的脑水肿,应该重视介入治疗所导致的CIRI。Objective To investigate the imaging Changes of cerebral ischemia reperfusion injury（CIRI） after interventional therapy in acute middle cerebral artery occlusion. Methods 32 patients with acute middle cerebral artery occlusion in our hospital from January 2013 to November 2014 were selected. 16 cases were performed the recanalization therapy after arterial thrombolysis and/or mechanical thrombeetomy（recanalization group） and 16 cases were not treated by thrombolytic therapy （non-recanalization group）. The differences of brain imaging changes（onset,on 3,7 d after onset） were analyzed and compared between the two groups. Results The.proportion of lateral ventricle compression degree and the shift degree of brain midline on 3 d after onset in the reca- nalization group were greater than those in the non-recanalization group, the differences between the two groups were statistically significantl-0.50± 0.1t vs. O. 58±0.10,0.57（0.18,0.83）cm vs. O. 22（0,0.57）cm,P〈0.05],while which on 7 d of onset in the recanalization group were less than those in the non-recanalization groupl-0. 80±0. 11 vs. O. 55±0.12,0（0,0. 13） vs. O. 46（0, 0.88）cm,P〈0. 055＂]. Conclusion Although the interventional therapy is an important measure for early treatment of ischemic stroke,but it aggravates the early brain edema, therefore CIRI induced by the interventional therapy should be paid more attention to.

关 键 词：大脑中动脉闭塞 介入治疗 缺血再灌注损伤 脑水肿 

分 类 号：R743.3[医药卫生—神经病学与精神病学]