侧支循环评价对大脑中动脉重度狭窄的急性缺血性脑卒中功能结局的预测作用  

Predictive effect of collateral circulation on severe stenosis or occlusion of middle cerebral artery in patients with acute ischemic stroke

作　　者：李军涛[1] 霍会永[1] 赵萍[1] 曹凌[1] 刘冰[1] 赵现[1] 袁志岭 Li Juntao;Huo Huiyong;Zhao Ping;Cao Ling;Liu Bing;Zhao Xian;Yuan Zhiling(Department of Neurology,the Handan Central Hospital,Hebei 056001,China)

机构地区：[1]邯郸市中心医院神经内二科,河北056001 [2]邱县中医院内科

出　　处：《脑与神经疾病杂志》2018年第10期601-604,共4页Journal of Brain and Nervous Diseases

基　　金：邯郸市科学技术研究与发展计划项目(1623208063-3)

摘　　要：目的探讨大脑中动脉重度狭窄或闭塞的急性缺血性脑卒中(AIS)患者侧支循环代偿评价对临床功能结局的预测作用。方法收集伴大脑中动脉重度狭窄或闭塞的AIS患者79例,采用DSA评估患者颅内侧支循环代偿情况,根据侧支循环代偿途径分为Willis动脉环开放组和未开放组,根据侧支循环代偿程度分成侧支循环代偿良好组、代偿中等组和代偿差组;对患者入院及出院时进行神经功能缺损评分(NIHSS),90d随访时用改良Rankin(mRS)量表衡量AIS患者神经功能恢复状况。结果 Willis环开放患者37例,未开放患者42例,两组患者入院和出院时NIHSS评分及90d mRS评分比较差异无统计学意义(P>0.05);侧支循环代偿较好组患者入院和出院时NIHSS评分及90d mRS评分显著低于侧支循环代偿差组(P<0.05)。结论大脑中动脉重度狭窄或者闭塞的AIS患者,侧支循环代偿程度与神经功能缺损程度相关,能够预测90d临床功能结局。Objective To evaluate the collateral circulation on severe stenosis or occlusion of middle cerebral artery in patients with acute ischemic stroke（AIS）. MethodCollected 79 cases of patients with severe stenosis or occlusion of middle cerebral artery with AIS. Digital subtraction angiography （DSA） was used to evaluate intracranial collateral circulation. Patients were divided into Willis ring opened group and unopened group according the open way of collateral circulation. Furthermore, patients were divided into good group, medium group and bad group according to the degree of collateral circulation compensation. Nerve function defect score （NIHSS） after admission and discharged and modified Rankin scale （mRS） followed up 90 days were measured. Results There were 37 cases of Willis ring opened patients and 42 cases of unopened patients. The comparisons of NIHSS after admission and discharged and mRS scores were not statistically significant in two groups （P〉0.05）. However, NIHSS after admission and discharged and mRS scores in good collateral circulation group were significantly lower than those in bad group （P〈0.05）. Conclusion In stroke patients with severe stenosis or occlusion of middle cerebral artery, the degree of collateral circulation compensation is correlated with neurologic defect, which also can predict the clinical outcome of 90 days.

关 键 词：急性缺血性脑卒中 大脑中动脉严重狭窄 神经功能缺损 WILLIS动脉环 侧支循环 

分 类 号：R743.3[医药卫生—神经病学与精神病学]