摘要
目的探讨经颅多普勒超声(TCD)评价大面积脑梗死患者侧支循环预测神经功能转归的价值。方法连续纳入的急性颈内动脉闭塞导致大面积脑梗死患者57例,根据TCD检测到的前交通动脉(ACoA)、后交通动脉(PCoA)、眼动脉的代偿情况分为ACoA合并PCoA代偿组19例、单纯ACoA代偿组13例、单纯PCoA代偿组10例、单纯眼动脉代偿组5例及无侧支代偿组10例,比较各组2周时美国国立卫生研究院卒中量表(NIHSS)评分和6个月时Barthel指数及其改善程度。结果 5组发病2周时NIHSS评分及改善程度比较,ACoA合并PCoA代偿组、单纯ACoA代偿组和单纯PCoA代偿组明显好于单纯眼动脉代偿组及无侧支代偿组,差异有统计学意义(P<0.05);5组随访6个月时Barthel指数及改善程度比较,ACoA合并PCoA代偿组、单纯ACoA代偿组和单纯PCoA代偿组明显好于单纯眼动脉代偿组及无侧支代偿组,差异有统计学意义(P<0.05)。结论对于颈内动脉闭塞导致大面积脑梗死患者急性期ACoA、PCoA侧支代偿较眼动脉侧支代偿可预测更好的近、远期神经功能转归,且ACoA合并PCoA侧支代偿可进一步促进远期的神经功能恢复。
Objective To study the transcranial Doppler ultrasonography in predictiing neurological function recovery of acute collateral circulation after massive cerebral infarction due to internal carotid artery occlusion. Methods Fifty-seven patients with massive cerebral infarction due to acute internal carotid artery occlusion were divided into combined ACoA and PCoA group （n = 19）, ACoA group （n=13）,PCoA group （n= 10）, OA group （n= 5） and non-collateral compensation group （n = 10） according to their transcranial Doppler ultrasonographic outcome. The NIHSS score at week 2 of follow-up and the Barthel index at month 6 of follow-up were observed. Results The NIHSS score at week 2 of follow-up in combined ACoA and PCoA group, ACoA group and PCoA group than in OA group and non-collateral compensation group （P〈0.05）. The Barthel index at month 6 of follow-up was significantly higher in combined ACoA and PCoA group than in ACoA group,PCoA group,OA group and non-collateral compensation group （P〈0.05）. Conclusion The short-term and long-term effect of ACoA and PCoA on neurological function recovery is better than that of OA and non-collateral compensation, and combined ACoA and PCoA can further promote the long-term neurological function recovery in patients with massive cerebral infarction due to internal carotid artery occlusion.
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2013年第8期838-841,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
广东省科技计划项目(2011B031800130)
深圳市重点科技计划项目(201101020)
关键词
脑梗死
超声检查
多普勒
经颅
侧支循环
颈动脉狭窄
眼动脉
brain infarction
ultrasonography, Doppler, transcranial
collateral circulation
carotid stenosis
ophthalmic artery
