单侧颈内动脉重度狭窄或闭塞患者侧支循环与临床预后的关系  

Association between collateral circulation and clinical outcome in patients with unilateral internal carotid artery severe stenosis or occlusion

作　　者：吴竹青[1,2,1] 汪国宏[1,2] 王小强[1,2] 群森[1,2] 岳宏[1,2] 张持[1,2] 吴君仓[1,2] 

机构地区：[1]安徽医科大学附属合肥医院 [2]合肥市第二人民医院神经内科,230011

出　　处：《中华老年心脑血管病杂志》2015年第5期463-465,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：安徽省2013年第三批科技计划项目(1301043051)

摘　　要：目的探讨单侧颈内动脉重度狭窄或闭塞的缺血性脑卒中患者侧支循环与临床预后的关系。方法选择经CT血管成像(CTA)检查证实有单侧颈内动脉重度狭窄或闭塞的急性缺血性脑卒中患者40例,分为重度狭窄组21例和闭塞组19例。并分为有侧支循环29例和无侧支循环11例,记录入院时、入院后2周、随访时美国国立卫生研究院卒中量表(NIHSS)评分,分析侧支循环与临床预后的关系。结果重度狭窄组有侧支循环开放12例(57.14%),闭塞组有侧支循环开放17例(89.47%),闭塞组侧支循开放率明显高于重度狭窄组(P=0.02)。29例有侧支循环建立的患者中初级代偿19例(65.52%),次级代偿10例(34.48%,P<0.05)。重度狭窄组初级代偿比例明显高于次级代偿比例(76.92%vs 23.08%,P<0.01)。有侧支循环2周NIHSS评分[(4.1±1.7)分vs(12.0±2.6)分,P=0.037]和随访时NIHSS评分[(1.9±1.2)分vs(10.4±2.4)分,P=0.000]较无侧支循环明显降低。结论侧支循环建立与动脉血管狭窄程度有一定相关性,初级侧支代偿是其主要代偿方式。Objective To study the association between collateral circulation and clinical outcome in ischemic stroke（IS）patients with unilateral internal carotid artery severe stenosis or occlusion.Methods Forty acute IS patients with CTA-confirmed unilateral internal carotid artery severe stenosis or occlusion were divided into severe stenosis group（n=21）and occlusion group（n=19）.Their intracranial collateral circulation and compensation were analyzed following unilateral internal carotid artery stenosis or occlusion.The patients were further divided into collateral circulation group（n=29）and non-collateral circulation group（n=11）.Their NIHSS scores were recorded on admission,2weeks after admission,and during follow-up（3months after onset of disease）.The association between collateral circulation and clinical outcome was analyzed.ResultsThe opening rate of collateral circulation was significantly higher in occlusion group than in severe stenosis group（89.47%vs 57.14%,P=0.02）.The rate of primary compensation was significantly higher than that of secondary compensation in collateral circulation group than in non-collateral circulation group and in severe stenosis group than in occlusion group（65.52% vs 34.48%,P〈0.05;76.92%vs 23.08%,P〈0.01）.Conclusion Collateral circulation is associated with carotid artery stenosis,and primary collateral compensation is its main compensation way.Ophthalmic artery plays an important role in primary collateral compensation.

关 键 词：颈动脉狭窄 侧支循环 卒中 血管造影术 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]