颞前动脉的存在与急性动脉粥样硬化性大脑中动脉闭塞患者梗死模式及临床预后的相关性研究

发布时间：2018-04-04 04:44

  本文选题：卒中预后　切入点：颞前动脉　出处：《医学研究生学报》2016年11期

【摘要】：目的颞前动脉是大脑中动脉第一个主要分支血管。在急性大脑中动脉(middle cerebral artery,MCA)闭塞患者中,其可提供潜在血流,继而改变脑组织坏死进程。文中旨在探讨通过分析急性动脉粥样硬化性MCA的M1段(middle cerebral artery-M1 segment,MCA-M1)闭塞后颞前动脉存在与梗死模式及梗死体积的改变,并探讨其对患者临床预后的影响。方法选取南京卒中注册系统中2007年1月至2013年12月,因首发缺血性卒中且影像学检查提示为动脉粥样硬化性MCA闭塞的患者116例。同时依据有无颞前动脉分为2组:55例患者存在颞前动脉(颞前动脉存在组),61例患者颞前动脉缺失(颞前动脉缺失组)。于入院期间均完成头颅MRI及血管学检查。对2组进行临床基础资料的比较,采用Alberta卒中项目早期CT评分方式分析组间病灶面积的差异,并采用改良Rankin量表(modified rankinscale,mRS)评估患者3个月功能预后。最后采用多因素Logistic回归分析3个月预后良好(mRS≤2)的独立预测因素。结果颞前动脉存在组入院国立卫生院神经功能评分(National Institute of Health Stroke Scale,NIHSS)、出院NIHSS评分较颞前动脉缺失组显著降低,且ASPECTS评分≥7分、mRS评分≤2分例数显著升高(P0.05)。颞前动脉存在组多区域病灶梗死、穿通支动脉区域梗死的发生率明显低于颞前动脉缺失组(34.6%vs 53.1%,38.5%vs 57.8%,P0.05);mRS评分≤2发生率明显高于颞前动脉缺失组(73.1%vs 35.9%,P0.001)。55例(47.4%)患者3个月功能预后良好,多因素logistic回归分析显示颞前动脉存在(OR=0.188,95%CI:0.062~0.572)、入院NIHSS评分(OR=1.578,95%CI:1.326~1.878)是患者3个月预后良好的独立预测因素。结论颞前动脉存在能够减小急性动脉粥样硬化性MCA-M1段闭塞患者梗死体积,改善患者临床功能预后。
[Abstract]:Objective the anterior temporal artery is the first major branch of the middle cerebral artery.In patients with acute middle middle cerebral artery occlusion (MCA), it provides potential blood flow and changes the progression of brain necrosis.The purpose of this study was to investigate the changes of anterior temporal artery (ACA) pattern and infarct volume after acute atherosclerotic MCA (M1) middle cerebral artery-M1 segmenting (MCA-M1) occlusion, and to explore its effect on clinical prognosis.Methods from January 2007 to December 2013, 116 patients with atherosclerotic MCA occlusion were selected from Nanjing Stroke Registration system.At the same time, the anterior temporal artery was divided into two groups according to the presence or absence of anterior temporal artery. There were 55 patients with anterior temporal artery (group A) and 61 patients with loss of anterior temporal artery (absence of anterior temporal artery).Cranial MRI and vascularization were performed during admission.The basic clinical data of the two groups were compared. The difference of lesion area between the two groups was analyzed by Alberta stroke project early CT scoring method, and the 3-month functional prognosis was evaluated by modified Rankin scale scale (modified Rankin scale).Finally, multivariate Logistic regression analysis was used as an independent predictor of good prognosis in 3 months (Mrs 鈮，

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