进展性脑梗死脑侧支循环形成及其对近期神经功能的影响

目的探讨进展性脑梗死患者脑侧支循环的形成情况及其对近期神经功能的影响。方法根据352例急性脑梗死患者头部CTA影像结果,分析进展性脑梗死患者侧支循环的形成情况,采用NIHSS评分及ADL评分法评价患者入院时及治疗14d时的神经功能缺损程度及日常生活活动能力,分析侧支循环的形成对近期神经功能的影响。结果 (1)352例急性脑梗死患者中,进展性脑梗死97例(27.6%),非进展性脑梗死255例(72.4%)。进展性脑梗死97例中,无侧支循环形成56例(57.7%),有侧支循环形成41例(42.3%);非进展性脑梗死255例中,无侧支循环形成者99例(38.8%),有侧支循环形成者156例(61.2%)。进展性脑梗死患者较非进展性脑梗死患者侧支循环形成几率低(χ2=10.195,P=0.002)。(2)在进展性脑梗死患者97例中,无侧支循环形成患者治疗14d时NIHSS评分及ADL缺陷程度均明显高于有侧支循环形成组(t=2.567,P=0.012;Z=-2.152,P=0.031);在非进展性脑梗死患者255例中,无侧支循环形成者治疗14d时NIHSS评分及ADL缺陷程度均明显高于有侧支循环形成者(t=2.371,P=0.019;Z=-2.437,P=0.015)。结论进展性脑梗死患者侧支循环形成状况差,无侧支循环形成的急性脑梗死患者近期神经功能恢复差。无侧支循环形成的急性脑梗死患者容易发生进展,且近期神经功能恢复差。

The formation of collateral circulation in progressive cerebral infarction and its effects on early neurological function

Objective To explore the formation of collateral circulation in patients with progressive cerebral infarction and its effect on early neurological function.Methods CTA imaging results of 352 patients with acute cerebral infarction were collected to analyze the formation of collateral circulation of progressive cerebral infarction.The degree of neurological deficits and activities of daily living evaluated by NIHSS score and ADL score in patients were collected on admission and treatment for 14 days to investi-gate the effect of the formation of collateral circulation on the early neurological function.Results (1)In 352 cases of acute cere-bral infarction,97 cases (27.6%)were progressive cerebral infarction and 255 cases (72.4%)were non-progressive.In 97 cases of progressive cerebral infarction,56 cases (57.7%)were with none collateral and 41 cases (42.3%)were with collaterals;In 255 ca-ses of non-progressive cerebral infarction,99 cases (38.8%)had none collateral and 156 cases (61.2%)had collaterals.The pro-portion of collateral circulation in progressive cerebral infarction was lower than in non-progressive(χ2 =10.195,P =0.002).(2)In 97 cases of progressive cerebralinfarction,the NIHSS scores and the degree of ADL deficiency on admission and treatment for 14 days in none collateral group were significantly higher than in collaterals group (t =2.567,P =0.012;Z =-2.152,P =0.031);In 255 cases of non-progressive cerebral infarction,the NIHSS scores and the degree of ADL deficiency on admission and treatment for 14 days in none collateral group were also significantly higher than in collaterals group (t =2.371,P =0.019;Z = -2.437, P =0.015).Conclusions Poor collateral circulation in patients with progressive cerebral infarction,the recovery of neurological function in patients with acute cerebral infarction without collateral circulation was poor.