侧支循环代偿方式对大脑中动脉区脑梗死患者神经功能缺损的影响  

Effect of collateral circulation compensatory methods on neurologic impairment in patients with middle cerebral artery cerebral infarction

作　　者：隋强波 孙华玲 

机构地区：[1]威海市中心医院神经外科,264400

出　　处：《国际医药卫生导报》2017年第1期25-28,共4页International Medicine and Health Guidance News

摘　　要：目的探讨侧支循环代偿方式对大脑中动脉区脑梗死患者神经功能缺损的影响。方法收集2011年4月至2014年1月在本院神经外科病房住院治疗的MCA区脑梗死患者74例，根据患者TCD检查提示的代偿方式分为ACA代偿组（n=45）、ACA＋PCA代偿组（n=17）、PCA代偿组（n=12）。比较3组侧支循环分级、脑梗死体积、神经功能缺损（NIHSS）、功能残疾程度（MRS）评分情况，分析NIHSS评分、MRS评分与梗死体积、侧支循环等级的关系。结果PCA代偿组患者侧支循环等级主要集中在I级，ACA＋PCA代偿组以Ⅲ级为多，ACA代偿组以Ⅱ级为主（P〈0．05）。PCA代偿组梗死体积为（67．2±19．7）cm3、ACA代偿组为（41．6±9．1）cm3、ACA＋PCA代偿组为（21．7±6．2）cm3，3组比较差异有统计学意义（P〈0．05）。发病时、发病后6个月时，ACA＋PCA代偿组NIHSS评分、MRS评分明显低于ACA代偿组，ACA代偿组明显低于PCA代偿组（均P〈0．05）。NIHSS评分、MRS评分与梗死体积均呈正相关（均P〈0．05），与侧支循环等级呈负相关（P〈0．05）。结论侧支循环代偿方式对大脑中动脉区脑梗死患者的神经功能恢复会产生不同的影响，ACA＋PCA代偿能更有效的改善梗死区血流供给，缩小梗死灶体积，保护神经细胞，利于神经功能的恢复。Objective To investigate the effect of collateral circulation compensatory methods on neurologic impairment in patients with middle cerebral artery cerebral infarction. Methods 74 patients with cerebral infarction at MCA district treated at our department from April, 2011 to January, 2014 were collected and. According to the compensatory methods suggested by TCD examination, they were divided into an ACA compensatory group （ n=45 ）, an ACA＋PCA compensatory group （ n=17 ）, and a PCA compensatory group （ n= 12 ）. The collateral circulation grade, cerebral infarction volume, neurological function defect （ NIHSS ） , and functional disability degree （ MRS ） score were compared between these three groups. The relationships of NIHSS score and MRS score with infarction volume and collateral circulation grade were analyzed. Results The collateral circulation grade mainly concentrated in grade I in the PCA compensatory group, grade III in the ACA＋PCA compensatory group, and grade II in the ACA compensatory group （ P〈 0.05 ） . The infarction volume was （ 67.2±19.7 ） cm3 in the PCA compensation group （ 67.2±19.7 ） cm3, （ 41.6±9.1 ） cm3 in the ACA compensatory group, and （ 21.7±6.2 ） cm3 in the ACA＋PCA compensatory group, with statistical differences （ P〈0.05 ） . When disease onset and 6 months after disease onset, the NIHSS score and MRS score were significantly lower in the ACA＋PCA compensatory group than in the ACA compensatory group and were in the ACA compensatory group than in the PCA compensatory group （ P〈0.05 ） . The NIHSS score and MRS score positively correlated with infarction volume （ P〈0.05 ） and negatively with collateral circulation grade （ P〈0.05 ） . Conclusions Different collateral circulation compensatory methods have effects on neural function recovery in patients with cerebral infarction at MCA district. ACA＋PCA compensatory can more effectively improve the blood supply of infarction area, reduce cerebral infarction volume, pr

关 键 词：侧支循环代偿 大脑中动脉 脑梗死 神经功能缺损 

分 类 号：R743.33[医药卫生—神经病学与精神病学]