症状性颈动脉重度狭窄/闭塞患者证候要素与前交通动脉开放的关系

目的 研究症状性颈动脉重度狭窄/闭塞患者证候要素与前交通动脉开放的关系.方法 采集36例症状性颈动脉重度狭窄/闭塞患者,含脑梗死26例、短暂性脑缺血发作(TIA)10例.采集5个时点证候要素,利用CT血管造影(CTA)联合磁共振血管成像(MRA)评估一级侧支循环,按前交通动脉是否开放分组,对预后以及证候要素进行统计学分...

Relationship between syndrome elements and anterior communicating artery opening in patients with smptomatic severe carotid artery stenosis/occlusion

Objective To study the relationship between syndrome elements and anterior communicating artery(ACoA)opening in patients with symptomatic severe carotid artery stenosis/occlusion.Methods Thirty-six patients with symptomatic severe carotid stenosis/occlusion were collected,including 26 patients with cerebral infarction and 10 patients with transient ischemic attack(TIA).Syndrome elements at five time points were collected.Computer tomography angiography(CTA)combined with magenic resonance angiograp(MRA)was used to evaluate the primary collateral circulation,and the prognosis and syndrome elements were statistically analyzed according to whether the ACoA was open or not.Results The ACoA was open more in the primary collateral circulation among patients with symptomatic severe carotid stenosis/occlusion.There was a statistically significant difference in national institute of health stroke scale(NIHSS)score improvement and good prognosis[the modified rankin scale(mRS)≤2]between the ACoA open group and the ACoA nonopen group on the 90th day(P<0.05).The proportion of patients with internal wind syndrome,blood stasis syndrome,Qi deficiency syndrome,and Yin deficiency syndrome in the ACoA non-open group was higher than that in the open group.Conclusion In the patients with severe carotid artery stenosis/occlusion,the group with presence of anterior communicating artery had better prognosis.The syndrome elements are more complex in the group without the presence of anterior communicating artery.The proportion of Qi deficiency syndrome was positively correlated with the non-opening of anterior communicating artery.The imaging evaluation of collateral circulation can provide guidance for syndrome differentiation and treatment.