摘要
目的:探讨症状性颈内动脉系统狭窄或闭塞患者的侧支循环开放特点及其与神经功能缺损的关系。方法:通过脑血管造影术评估288例症状性颈内动脉系统重度狭窄或闭塞患者的侧支循环开放特点,并比较侧支开放与患者入院时神经功能缺损(NIHSS评分)的关系。结果:288例患者共出现侧支循环开放166例,其中颈内动脉颅外段病变111例出现侧支74例(66.7%);颈内动脉颅内段病变45例出现侧支27例(60.0%);大脑中动脉病变125例出现侧支63例(50.4%);大脑前动脉病变7例出现侧支2例(28.5%)。在颈内动脉重度狭窄或闭塞的患者中,存在Willis环代偿或多侧支联合代偿者入院时神经功能缺损较无侧支代偿者轻(P<0.05);在颈内动脉及大脑中动脉重度狭窄或闭塞的患者中,仅靠软脑膜代偿者入院时神经功能缺损与无侧支代偿者间差异无统计学意义(P>0.05)。结论:症状性颈内动脉系统狭窄或闭塞患者可通过多种侧支代偿途径减轻神经功能损害,软脑膜侧支最多见而初级侧支Willis环代偿更有效。
Objective To explore the characteristics of collateral circulation with symptomatic internal carotid artery system stenosis or occlusion and its relationship with neurologic function impairment. Methods The characteristics of collateral circulation in 288 patients with symptomatic internal carotid artery system severe stenosis or occlusion were assessed by digital subtraction angiography （DSA）, and the relationship between collateral circulation and the National Institutes of Health Stroke Scale （NIHSS） on admission were analyzed. Results Among 288 cases, 166 were found to have collateral blood flow. In 111 patients with extracranial internal carotid artery lesions, 74 patients（66.7%）had collateral circulation. In 45 patients with intracranial internal carotid artery lesions, 27 patients （60.0%）had collateral circulation. In 125 patients with middle cerebral artery lesions, 63 patients （50.4%）had collateral circulation. In 7 patients with anterior cerebral artery lesions, 2 patients （28.5%）had collateral circulation. In patients with internal carotid artery severe stenosis or occlusion, the neurological function impairment was milder among those with Willis circle compensation or more collateral circulacion ways than patients with no collateral compensation （P 〈 0.05）. In patients with internal carotid artery and middle cerebral artery severe stenosis or occlusion, there was no statistical difference for the neurologic function impairment between the patients only with leptomeningeal anastomose and without collateral circulation （P 〉 0.05）. Conclusions Multiple ways of collateral circulation can be established in patients with symptomatic internal carotid artery system severe stenosis or occlusion in order to alleviate nearologic impairment, and leptomeningeal anastomose is the most frequent while the compensation by Willis circle way is more effective.
出处
《实用医学杂志》
CAS
北大核心
2014年第1期61-64,共4页
The Journal of Practical Medicine
基金
广西医疗卫生厅重点科研课题(编号:重2011115)
关键词
脑动脉狭窄或闭塞
侧支循环
脑血管造影
Cerebral artery stenosis or occlusion
Collateral circulation
Cerebral angiography
