重度颅内动脉狭窄与侧支循环代偿关系的研究  

The relationship between severe intracranial artery stenosis and collateral circulation

作　　者：霍会永[1] 赵萍[1] 曹凌[1] 刘冰[1] 赵现[1] 李军涛[1] Huo Huiyong;Zhao Ping;Cao Ling;Liu Bing;Zhao Xian;Li Juntao(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

出　　处：《脑与神经疾病杂志》2019年第10期598-601,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 分析颅内动脉狭窄部位与侧支循环的关系,探讨重度颅内动脉狭窄与侧支循环代偿的关系。方法 选择2015年1月至2017年6月因急性脑梗死(ACI)入院并行数字减影脑血管造影检查(DSA)患者97例,以颅内动脉狭窄程度≥70%为重度狭窄,依据狭窄部位分成两组:前循环狭窄组(63例)和后循环狭窄组(34例)。根据侧支循环代偿情况,分成有侧支循环组(56例)和无侧支循环组(41例)。结果 前循环狭窄组有侧支循环代偿比例显著高于后循环狭窄组患者;后循环狭窄组卒中进展加重患者比例及90d改良的Rankin(mRS)量表评分显著高于前循环狭窄组,无侧支循环代偿组卒中进展加重患者比例及90dmRS评分显著高于有侧支循环代偿组。结论 前循环严重狭窄患者更易于建立侧支循环,后循环狭窄及无侧支循环代偿患者卒中进展加重比例高,卒中预后差,侧支循环的建立有助于阻止病情进展、改善患者预后。Objective To analyze the association between the distribution of intracranial artery stenosis and collateral circulation and discuss the relationship between severe intracranial artery stenosis and collateral circulation in patients with acute cerebral infarction( ACI). Method From January 2015 and June 2017, 97 patients with ACI digital subtraction angiography(DSA) were analyzed, and intracranial artery stenosis degree was more than 70% as severe stenosis. They were divided into two groups according to the narrow area: anterior stenosis group( 63 cases), posterior group( 34 cases). In addition, they were divided into collateral circulation group( 56 cases) and non- collateral circulation group( 41 cases) according the compensation of collateral circulation. Results In the anterior circulation narrow group, the ratio of collateral circulation was significantly higher than in the the patients with posterior circulation stenosis group. Compared to anterior circulation narrow group, the stroke progression and Modified Rankin Scale( mRS) score was significantly increased in posterior circulation narrowing group. Furthermore, compared to the collateral circulation group, the stroke progression and mRS score was significantly increased in noncollateral circulation group. Conclusion Patients with severe anterior circulation are more likely to establish collateral circulation. Posterior circulation stenosis and the progress of stroke in patients without collateral circulation compensatory are higher. The establishment of collateral circulation helps to prevent progression of the disease and improve the prognosis of stroke.

关 键 词：急性脑梗死 颅内动脉狭窄 前循环 后循环 侧支循环 

分 类 号：R743.32[医药卫生—神经病学与精神病学]