基于DSA的颈内动脉与大脑中动脉狭窄或闭塞患者不同供血区脑梗死的对比分析  

Comparative analysis of DSA on cerebral infarction in different blood supply areas in patients with ICA and MCA stenosis or occlusion

作　　者：吴锡骅 梅益彰 苏施雅 任丽 WU Xi-hua;MEI Yi-zhang;SU Shi-ya;REN Li(Department of Neurology,Foshan Fosun Chancheng Hospital,Foshan 528000,Guangdong,China)

机构地区：[1]佛山复星禅诚医院神经内科,广东佛山528000

出　　处：《川北医学院学报》2022年第4期477-480,共4页Journal of North Sichuan Medical College

基　　金：广东省佛山市科技项目(1920001000474)。

摘　　要：目的:对比分析数字减影血管造影(DSA)在颈内动脉(ICA)与大脑中动脉(MCA)狭窄或闭塞患者不同供血区脑梗死中的应用价值。方法:按照病因不同将127例因ICA、MCA狭窄或闭塞所致的缺血性脑卒中患者分为ICA组(n=62)和MCA组(n=65)。患者均于入院后进行DSA检查,对ICA、MCA狭窄或闭塞患者不同供血区脑梗死进行对比分析,随访1年,记录两组预后情况。结果:ICA组分水岭梗死(BZI)发生率低于MCA组(P<0.05);两组皮质分支动脉供血区梗死(PI)、穿支动脉供血区梗死(PAI)及大面积梗死(LTI)发生率比较,差异无统计学意义(P>0.05);ICA组单发PI及各区单发性脑梗死合计发生率高于MCA组(P<0.05);两组PAI、BZI及LTI发生率比较,差异无统计学意义(P>0.05);ICA组PI+BZI及多发性脑梗死发生率低于MCA组(P<0.05);两组其他类型多发性脑梗死发生率比较,差异无统计学意义(P>0.05);ICA组1年内反复缺血性脑卒中发生率低于MCA组(P<0.05)。结论:ICA狭窄或闭塞患者以单发性脑梗死为主,MCA狭窄或闭塞患者以多发性脑梗死为主,且MCA狭窄或闭塞患者影像学表现比ICA狭窄或闭塞患者严重,预后更差。Objective:To compare and analyze the application value of digital subtraction angiography(DSA)on cerebral infarction in different blood supply areas in patients with internal carotid artery(ICA)and middle cerebral artery(MCA)stenosis or occlusion.Methods:127 patients with ischemic stroke due to ICA,MCA stenosis or occlusion were retrospectively selected,and they all underwent DSA examination after admission,including 62 cases in ICA group and 65 cases in MCA group.The cerebral infarction status in different blood supply areas of patients with ICA,MCA stenosis or occlusion were compared and analyzed.After 1 year of follow-up,the prognosis of the two groups was recorded.Results:The incidence rate of border-zone infarction(BZI)in ICA group was significantly lower than that in MCA group(P<0.05),and there were no statistical differences in the incidence rates of pial artery infarction(PI),perforating artery infarction(PAI)and large territorial infarction(LTI)between the two groups(P>0.05).The incidence rates of PI only and total incidence rate of single cerebral infarction in different areas were significantly higher in ICA group than those in MCA group(P<0.05),and there were no significant differences in the incidence rates of PAI,BZI and LTI between the two groups(P>0.05).The incidence rates of PI+BZI and multiple cerebral infarction in ICA group were significantly lower compared with those in MCA group(P<0.05),and there were no significant differences in the incidence rates of other types of multiple cerebral infarction between the two groups(P>0.05).The incidence rate of repeated ischemic stroke within 1 year was significantly lower in ICA group than that in MCA group(P<0.05).Conclusion:Patients with ICA stenosis or occlusion are mainly single cerebral infarction,and patients with MCA stenosis or occlusion are mainly multiple cerebral infarction.Compared with patients with ICA stenosis or occlusion,patients with MCA stenosis or occlusion have more serious imaging manifestations and worse prognosis.

关 键 词：脑梗死 数字减影血管造影 颈内动脉 大脑中动脉 

分 类 号：R743.33[医药卫生—神经病学与精神病学]