70例短暂性脑缺血发作患者的脑血管造影结果分析

目的探讨短暂性脑缺血发作（TIA）与颅内-外动脉狭窄的关系.方法对70例TIA患者的数字减影血管造影（DSA）资料进行分析,计算颅内-外动脉狭窄率,并对不同年龄组患者颈内动脉系统TIA（ICA-TIA）与椎-基底动脉系统TIA（VB-TIA）的颅内-外动脉狭窄或闭塞情况进行比较.结果 70例患者中,单纯颅外动脉、单纯颅内动脉及颅内-外动脉多发性狭窄或闭塞分别为30.0%（21/70）、28.6%（20/70）和32.9%（23/70）,颅外动脉狭窄或闭塞高于颅内动脉（53.3%、46.7%）.ICA-TIA组颅内动脉狭窄或闭塞稍高于颅外动脉（52.9%、47.1%）,VB-TIA组颅外动脉狭窄或闭塞明显高于颅内动脉（63.1%、36.9%）.ICA-TIA组单纯颅内动脉狭窄或闭塞高于VB-TIA组（45.2%、4.5%）,颅内-外动脉多发性狭窄或闭塞低于VB-TIA组（23.8%、59.1%）,两组单纯颅外动脉狭窄或闭塞相近（31.0%、36.4%）.在〈50岁组中,单 纯颅内动脉狭窄或闭塞为75.0%,以大脑中动脉病变为主（50.0%）,高于单纯颅外动脉、颅内-外动脉多发性狭窄或闭塞的10.0%及15.0%,而≥50岁组中,单纯颅内动脉狭窄或闭塞（11.4%）低于颅内-外多发性动脉狭窄或闭塞（45.5%）和单纯颅外动脉狭窄或闭塞（43.2%）,差异具有显著性.结论 DSA检查有助于明确TIA病因,对治疗具有指导意义.

Analysis of the cerebral digital subtraction angiographic findings of 70 patients with transient ischemic attack

Objective To discuss the relationship of transient ischemic attack in the patients with intra-and extracranial arterial stenosis. Methods Calculate the percentage of stenosis of the intra-and extracranial arteries in digital subtraction angiography of 70 patients with transient ischemic attack. And the percentage of stenosis of vessels in various age group and carotid artery and vertebral artery system was analyzed using statistic methods. Results 30% (21/70) of the cases had either extracranial artery occlusion or stenosis. 28.6% (20/70) of the cases had either intracranial artery occlusion or stenosis. 32.9% (23/70) of the cases had multiple intra-and extracranial arteries occlusion or stenosis. In general,there were more patients with extracranial stenosis than intracranial stenosis (53.3% vs. 46.7%). In patients with anterior circulation TIA(ICA-TIA),there were slightly more extracranial vessels stenosis than the intracranial vessels (52.9% vs. 47.1%). However,in patients with posterior circulation TIA(VA-TIA),there were much more extracranial vessels stenosis than the intracranial vessels(63.1% vs. 36.9%). In ICA-TIA group,there were more cases had only intracranial vessels stenosis than VA-TIA(45.2% vs.4.5%).There were fewer cases with multiple intra-and extracranial vessels stenosis than VB-TIA(23.8% vs.59.1%). There were almost equal cases with extracranial stenosis in both group(31.0% vs.36.4%). In patients younger than 50 year-old,the majority of the cases had only intracranial stenosis (75%) and MCA stenosis accounted for 50% of these cases,10% had only extracranial stenosis and 15% had multiple stenosis. In patients older than 50 year-old,only 11.4% of the cases had single intracranial artery stenosis and 45.5% had multiple stenosis and 43.2% had only extracranial artery stenosis,The difference was significant. Conclusion Digital subtraction angiography may clarify the causes of transient ischemic attack and guide the treatment.