急性动脉粥样硬化型脑梗死患者血管储备功能与介入治疗预后的相关性分析  

Correlation Analysis between Cerebrovascular Reserve and Prognosis of Patients with Acute Atherosclerotic Cerebral Infarction

作　　者：王琨[1] 侯国欣[1] 刘磊[1] 臧文举[1] 凌端强 王颍超 WANG Kun;HOU Guoxin;LIU Lei(Department of Interventional Therapy,Zhengzhou People’s Hospital,Zhengzhou City,He’nan Province 450000)

机构地区：[1]郑州人民医院介入科,河南省郑州市450000

出　　处：《医学理论与实践》2022年第12期1990-1992,1996,共4页The Journal of Medical Theory and Practice

摘　　要：目的:探讨急性脑梗死患者入院时的脑血管储备功能(CVR)与血管介入治疗预后的相关性。方法:选取我院收治的单侧急性动脉粥样硬化脑梗死患者98例,采用经颅多普勒(TCD)检测患者入院时的脑血流动力学变化并计算CVR;同时采用头颅MRA检测Willis环,评估脑血管结构功能。患者按照预后情况分为预后良好组和预后不良组。比较两组间各指标差异,Logistic回归分析影响患者介入治疗预后的危险因素。结果:预后良好组中高血压及高血脂患者的比例、年龄、LDL水平及NIHSS评分均明显低于预后不良组。预后良好组中CVR功能正常、Ⅰ型Willis环患者比例明显高于预后不良组,Ⅲ、Ⅳ型比例低于预后不良组。多因素分析显示,年龄、高血脂、血压、LDL、NIHSS及脑血管结构是预后的影响因素,而CVR正常是预后保护因素。结论:动脉粥样硬化型脑梗死患者的CVR功能显著降低,且与患者介入治疗的近期预后相关。Objective:To investigate the correlation between cerebral cerebrovascular reserve(CVR)and prognosis of patients with acute cerebral infarction after interventional therapy.Methods:98 patients with unilateral acute atherosclerotic cerebral infarction admitted to our hospital were selected.Transcranial Doppler(TCD)was used to detect the changes of cerebral hemodynamics at admission and the CVR was calculated.Head MRA was used to detect the Willis circle and evaluate the brain vascular structural function.According to the prognosis,the patients were divided into the good prognosis group and poor prognosis group.The difference of indexes between the two groups was compared,and the risk factors influencing the prognosis of patients after interventional therapy were analyzed by Logistic regression.Results:The proportion of hypertension or hyperlipidemia,age,LDL level and NIHSS score in the good prognosis group were significantly lower than the poor prognosis group.The proportion of normal CVR and typeⅠWillis in good prognosis group were significantly higher than the poor prognosis group,and typeⅢ,ⅣWillis ratio is lower than the poor prognosis group.Multivariate analysis showed that age,hyperlipidemia,blood pressure,LDL,NIHSS and cerebrovascular structure were prognostic factors,while normal CVR was prognostic protective factors.Conclusion:CVR is significantly reduced in patients with atherosclerotic cerebral infarction,and is associated with the short-term prognosis of interventional therapy.

关 键 词：脑梗死 脑血管储备 介入 预后 

分 类 号：R743.33[医药卫生—神经病学与精神病学]