颈内动脉狭窄或闭塞缺血性脑卒中患者侧支循环与临床症状的关系

发布时间：2018-09-01 13:23

【摘要】：目的：探讨颈内动脉重度狭窄或闭塞的缺血性脑卒中患者其侧支循环与临床症状的关系。方法：对110例单侧颈内动脉(ICA)重度狭窄或闭塞的急性缺血性脑卒中患者,行经颅多普勒(transcranial doppler ultrasonography, TCD)检查,了解侧支循环开放情况。根据TCD检测到的前交通动脉(ACOA).后交通动脉(PCOA)、眼动脉(OA)的代偿情况,将患者分为单纯ACOA开放组、单纯PCOA开放组、单纯OA开放组、ACOA合并PCOA开放组及无侧支循环开放组5组,比较各组入院时和住院2周时美国国立卫生研究院卒中量表(NIHSS)评分,以及入院时和6个月时改良Rankin评分(mRS)。结果：(1)110例患者中ACOA开放47例,占全部患者的43%。PCOA开放38例,占35%；OA开放28例,占25%。(2)无侧支循环开放组治疗前后NIHSS评分、mRS评分无明显差异(P0.05)。(3)治疗2周时,ACOA开放组、PCOA开放组、ACOA合并PCOA开放组NIHSS评分较OA开放组、无侧支循环代偿组明显降低(P0.05)。(3)ACOA合并PCOA开放组NIHSS评分明显低于单纯ACOA组,差异有统计学意义(P0.05)。(4)6个月随访时ACOA开放组、PCOA开放组、ACOA合并PCOA开放组mRS评分明显低于OA开放组和无侧支循环代偿组(P0.05)。结论：单侧颈内动脉重度狭窄或闭塞的缺血性脑卒中患者,前交通动脉开放是颅内侧支循环开放的主要途径,Willis环侧支开放类型与临床症状、预后密切相关。
[Abstract]:Objective: to investigate the relationship between collateral circulation and clinical symptoms in ischemic stroke patients with severe stenosis or occlusion of internal carotid artery. Methods: Transcranial Doppler (transcranial doppler ultrasonography, TCD) examination was performed in 110 patients with acute ischemic stroke with severe stenosis or occlusion of unilateral internal carotid artery (ICA). (ACOA). Of anterior communicating artery detected by TCD The (OA) compensation of posterior communicating artery (PCOA),) ophthalmic artery was divided into five groups: ACOA open group, PCOA open group, OA open group combined with PCOA open group and open collateral circulation group. The (NIHSS) score of the National Institutes of Health Stroke scale at admission and 2 weeks after hospitalization, and the modified Rankin score (mRS). At admission and 6 months were compared among the groups. Results: (1) among the 110 patients, 47 cases were open to ACOA, 38 cases were open to 43%.PCOA, and 28 cases were open to 35 cases of OA. (2) there was no significant difference in NIHSS score and Mrs score before and after treatment in the open group without collateral circulation (P0.05). (3). At 2 weeks after treatment, the NIHSS score of the open group with PCOA in the open group was higher than that in the open group of OA. The score of NIHSS in ACOA combined with open PCOA group was significantly lower than that in simple ACOA group (P0.05). (3). The difference was statistically significant (P0.05). (4) after 6 months follow-up, the mRS score of ACOA open group was significantly lower than that of OA open group and non-collateral circulation compensatory group (P0.05). Conclusion: in ischemic stroke patients with severe stenosis or occlusion of unilateral internal carotid artery, open anterior communicating artery is the main way to open intracranial collateral circulation. The type of open collateral of Willis is closely related to clinical symptoms and prognosis.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3

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