椎基底动脉重度狭窄或闭塞的侧支循环与后循环缺血相关性研究

目的应用减影头颈部CT血管造影(CTA)和数字减影血管造影(DSA)评价椎基底动脉重度狭窄或闭塞患者的侧支循环,探讨不同的侧支循环与后循环缺血(PCI)的相关性。方法选择2008年2月至2011年1月在赤峰市医院神经内科就诊的椎基底动脉重度狭窄或闭塞住院患者102例,根据CTA或DSA检查结果分为有侧支循环组和无侧支循环组,分析不同的侧支循环与PCI的相关性。结果有侧支循环组脑梗死发病率低于无侧支循环组(P=0.031);无侧支循环重症脑梗死患者比例较有侧支循环组高(P=0.043);有侧支循环组发病后30 d临床表现的好转率较高(P=0.021);有侧支循环的脑梗死组较短暂性脑缺血发作组侧支代偿方式少,差异有统计学意义(P=0.009)。结论有侧支循环的脑梗死发病率低、临床症状较轻、预后好,以多种侧支循环方式代偿的PCI患者临床症状较轻、预后好。

Study on Correlation between Collateral Circulation and Posterior Circulation Ischemia in Vertebrobasilar Severe Stenosis or Occlusion

Objective To investigate the correlation between different collateral circulation and posterior circulation ischemia through angiography evaluation of vertebrobasilar severe stenosis or occlusion of collateral circulation by subtraction CT angiography(CTA)and digital subtraction angiography(DSA).in patients.Methods 102 cases of confirmed vertebrobasilar severe stenosis or occlusion who visited department of neurology of Chifeng City Hospital during February 2008 to January 2011were divided into collateral circulation group and non-collateral circulation group according to CTA or DSA results,the correlation of different collateral circulations and PCI was analyzed.Results Collateral circulation group cerebral infarction incidence was lower than non-collateral circulation group(P=0.031);the proportion of patients with severe cerebral infarction of collateral circulation group was lower(P=0.043);improvement rate of clinical manifestations on 30 days after onset of collateral circulation group was higher(P=0.021);collateral circulation mode of collateral circulation group was less than a transient ischemic attack group,the difference was statistically significant(P=0.009).Conclusion Collateral circulation infarction group is featured with lower incidence,mild clinical symptoms,and better prognosis.The PCI patients with various decompensated collateral circulations have less clinical symptoms and good prognosis.