脑血管侧支循环评估在脑血管介入术后再狭窄及缺血性脑血管事件中的应用  

Application of cerebral vascular collateral circulation assessment in restenosis after cerebrovascular intervention and ischemic cerebrovascular events

作　　者：周桂桃 龚昭惠[1] 谈惠群[1] 何伟[1] 郭庆[1] 李静静 ZHOU Gui-tao;GONG Zhao-hui;TAN Hui-qun;HE Wei;GUO Qing;LI Jing-jing(Second Department of Geriatrics,Huangshi Central Hospital,Huangshi 435000,Hubei,CHINa)

机构地区：[1]黄石市中心医院老年病科二病区,湖北黄石435000

出　　处：《海南医学》2018年第18期2534-2537,共4页Hainan Medical Journal

摘　　要：目的探讨脑血管侧支循环评估在脑血管介入术后再狭窄及缺血性脑血管事件中的临床应用价值。方法选择黄石市中心医院老年病科2014年9月至2017年5月收治的104例住院拟进行脑血管介入术的患者为研究对象。所有患者采用脑血管数字减影血管造影(DSA)进行脑血管检查,根据DSA检查结果,按照ASITN/SIR侧支血流分级系统对患者的侧支血流进行分级。术后6个月对患者再次进行DSA检查,根据检查结果,采用NASCET标准进行动脉狭窄程度的评估和再狭窄的评价。患者介入术后6个月,由专人负责随访,观察不良缺血性脑血管事件。结果本组104例患者中,不同侧支循环开放程度患者的体质量、体质量指数、性别比例和病史比较差异无统计学意义(P>0.05);无侧支循环组患者的ASITN/SIR侧支血流分级均为0级,一级侧支循环组患者的ASITN/SIR侧支血流分级分别为0级(36.17%)和1级(63.83%),二级侧支循环组患者中侧支血流分级分别为1级(36.84%)、2级(52.63%)和3级(10.53%),三级侧支循环组患者中侧支血流分级分别为2级(20.00%)和3级(80.00%),侧支循环分级越高,侧支血流分级也随着增高的趋势,差异有统计学意义(P<0.05)。术前,患者无狭窄和轻度狭窄的比例随着侧支循环开放程度的升高而降低,中度狭窄和重度狭窄则随着侧支循环开放程度的升高而升高,差异有统计学意义(P<0.05);随着侧支循环开放程度的升高,患者在脑血管介入术后发生再狭窄的概率降低,脑血管介入术后预后效果升高,差异有统计学意义(P<0.05)。结论脑血管侧支循环评价对改善脑血管介入术预后及治疗效果,制定相应的个体化治疗及预后方案具有重要的指导意义。Objective To determine the clinical application value of cerebral vascular collateral circulation assessment in restenosis after cerebrovascular intervention and ischemic cerebrovascular events. Methods A total of 104 patients hospitalized for cerebrovascular interventional surgery were selected from the Second Department of Geriatrics in the Huangshi Central Hospital during September 2014 and May 2017. All patients underwent cerebrovascular digital subtraction angiography（DSA） for cerebrovascular examination. According to the results of DSA examination, the collateral blood flow of each patient was graded according to the ASITN/SIR collateral flow grading system. The patient was re-evaluated for DSA 6 months after surgery. According to the results of the examination, the degree of arterial stenosis and the occurrence of restenosis were evaluated by NASCET criteria. Six months after the intervention, the patients were followed up by responsible person to observe the adverse ischemic cerebrovascular events. Results Among the104 patients in this study, there was no significant difference in body weight, body mass index, sex ratio and medical history between patients with different collateral circulation opening degree; all differences were not statistically significant（P〈0.05）. The patients without collateral circulation all had ASITN/SIR collateral blood flow grade of 0. The patients with collateral grade-1 had ASITN/SIR grades of 0（36.17%） and 1（63.83%）. The patients with collateral grade-2 had ASITN/SIR grades of 1（36.84%）, 2（52.63%） and 3（10.53%）. The patients with collateral grade-3 had ASITN/SIR grades of 2（20.00%） and 3（80.00%）. The higher the collateral circulation degree, the higher the collateral blood flow grading, and the trend was statistically significant（P〈0.05）. Before operation, the proportion of patients without stenosis and mild stenosis decreased with the increase of collateral circulation opening degree; while the proportion of patients with moderate

关 键 词：脑血管侧支循环评价 脑血管介入术 再狭窄 缺血性脑血管事件 

分 类 号：R743[医药卫生—神经病学与精神病学]