急性缺血性脑卒中患者溶栓治疗前后侧支循环变化及其与自主神经功能恢复的相关性分析  

Changes in collateral circulation and their correlation with the recovery of autonomic nervous system function in patients with acute ischemic stroke before and after thrombolytic therapy

作　　者：赵聪聪 刘盼盼 曹皓月 ZHAO Cong-cong;LIU Pan-pan;CAO Hao-yue(Department of Emergency,Xingtai Central Hospital,Xingtai Hebei 054000,China)

机构地区：[1]邢台市中心医院急诊科,河北邢台054000

出　　处：《临床和实验医学杂志》2024年第22期2357-2360,共4页Journal of Clinical and Experimental Medicine

基　　金：河北省重点研发计划项目(编号:2021ZZ016);河北省邢台市重点研发计划自筹项目(课题编号:2022ZC252)。

摘　　要：目的探讨急性缺血性脑卒中患者溶栓治疗前后侧支循环变化及其与自主神经功能恢复的相关性。方法回顾性选取2021年1月至2024年1月邢台市中心医院收治的80例急性缺血性脑卒中患者作为研究对象。所有患者均采取溶栓治疗,分析所有患者治疗前后侧支循环改善情况,对比侧支循环改善与未改善患者神经功能缺损程度,对比其入院时、治疗后2周、治疗后1个月、治疗后3个月美国国立卫生研究院卒中量表(NIHSS)评分。随后对所有患者进行3个月门诊复查随访,将NIHSS≤6分的60例患者判定为自主神经功能恢复,分为恢复组,将其余20例患者分为未恢复组,对比其治疗前后病灶侧血流参数,采用Spearman相关分析法分析相关血流参数与自主神经功能恢复的相关性。结果80例患者中治疗前眼动脉、后交通、前交通侧支循环代偿患者数量分别为23、25、32例,治疗后为10、14、21例,治疗后与治疗前相比,差异有统计学意义(P<0.05)。共45例患者侧支循环未改善,35例患者侧支循环改善。侧支循环未改善及侧支循环改善改善患者神经功能缺损程度为轻度、中度、重度的分布比较,差异有统计学意义(P<0.05),侧支循环未改善患者重度神经功能缺损程度患者比率为34.29%,高于侧支循环改善组(15.56%),差异有统计学意义(P<0.05)。入院时不同侧支循环改善情况患者NIHSS评分对比无明显差异,治疗后2周、治疗后1个月、治疗后3个月两组患者NIHSS评分均降低,且侧支循环改善患者NIHSS评分低于对照组,差异均有统计学意义(P<0.05)。治疗前、治疗后3个月恢复组患者rCBF、rCBV水平均高于未恢复组,rTTP、rMTT水平均低于未恢复组,差异均有统计学意义(P<0.05)。Spearman相关分析结果表明,治疗前rCBF、治疗前rCBV、治疗后rCBF、治疗后rCBV与缺血性脑卒中患者自主神经功能恢复水平呈正相关(P<0.05),治疗前rTTP、治疗前rMTT、�Objective To explore the changes in collateral circulation and their correlation with the recovery of autonomic nervous system function in patients with acute ischemic stroke before and after thrombolytic therapy.Methods A total of 80 patients with acute ischemic stroke admitted to Xingtai Central Hospital from January 2021 to January 2024 were retrospectively selected.All patients were treated with thrombolytic therapy,and the improvement of collateral circulation before and after treatment was analyzed,and the degree of neurological deficit in patients with improved collateral circulation was compared with those who did not,and National Institute of Health stroke scale(NIHSS)scores were compared at admission,2 weeks after treatment,1 month after treatment,and 3 months after treatment.Subsequently,all patients were followed up for 3 months in outpatient clinics,and 60 patients with NIHS≤score of 6 were judged to have recovered autonomic function and divided into recovery group,and the remaining 20 patients were divided into non-recovery group.Results Among the 80 patients,the number of patients with ophthalmic artery,posterior communicating artery and anterior communicating collateral circulation compensation before treatment was 23 cases,25 cases and 32 cases,respectively,and 10 cases,14 cases and 21 cases after treatment.Compared with before treatment,the difference was statistically significant(P<0.05).A total of 45 patients had no improvement in collateral circulation,and 35 patients had improved collateral circulation.There were significant differences in the distribution of mild,moderate and severe neurological deficits in patients with no improvement of collateral circulation and improvement of collateral circulation(P<0.05).The proportion of patients with severe neurological deficits in patients with no improvement of collateral circulation was 34.29%,which was higher than that in the collateral circulation improvement group(15.56%),and the difference was statistically significant(P<0.05).There was no

关 键 词：急性缺血性脑卒中 侧支循环 神经功能 脑血流量 相关性 脑血容量 

分 类 号：R743.3[医药卫生—神经病学与精神病学]