颈内动脉颅外段狭窄患者96例临床分析

目的探讨颈内动脉颅外段狭窄患者大脑中动脉的平均血流速度(MV)和发生脑分水岭梗死的情况。方法选取符合纳入标准的颈内动脉颅外段严重狭窄患者96例,均用经颅多普勒检查仪检测同侧大脑中动脉的MV,根据大脑中动脉的MV降低程度将患者分为四组,A组:MV正常组20例;B组:MV轻度降低组36例;C组:MV中度降低组32例;D组:MV重度降低组8例。对各组患者进行美国国立卫生研究院卒中量表(NIHSS)评分,并进行头颅CT和(或)磁共振成像检查以确定分水岭梗死情况。结果 A、B、C、D四组患者的NIHSS评分分别为(3.0±1.3)分、(4.8±2.0)分、(5.2±2.5)分、(12.8±4.5)分,四组比较差异有统计学意义(F=56.18,P<0.01);A、B、C、D四组发生分水岭梗死的比率分别为20.0%、38.9%、62.5%、50.0%,四组比较差异有统计学意义(χ2=9.63,P<0.05)。结论颈内动脉颅外段狭窄患者的NIHSS评分随着MV的降低逐渐升高,病情越重,患侧MV越低,发生脑分水岭梗死的概率越高。

Clinical Analysis of 96 Patients with Internal Carotid Artery Extracranial Stenosis

Objective To investigate the mean blood velocity(MV) in arteria cerebri media of patients with internal carotid artery extracranial stenosis and the situation of the occurrence of cerebral watershed infarction.Methods 96 patients with internal carotid artery extracranial stenosis were selected and the transcranial Doppler examination was used to detect the MV of ipsilateral middle cerebral artery.According to the MV reduction degree of middle cerebral artery,the patients were divided into 4 groups,group A:MV normal group of 20 cases;group B:MV mildly reduced group of 36 cases;group C:MV moderately reduced group of 32 cases;group D:MV severely reduced group of 8 cases.NIHSS score was performed for each group and check of skull CT/MRI was conducted to determine the watershed infarction.Results NIHSS scores of group A,B,C,D were(3.0±1.3),(4.8±2.0),(5.2±2.5),(12.8±4.5),there was significant difference between the four groups(F=56.18,P<0.01);the watershed infarction ratios of group A,B,C,D were 20%,38.9%,62.5%,50%,there was significant difference between the four groups(χ2=9.63,P<0.05).Conclusion NIHSS scores gradually increased with MV decrease of the patients with internal carotid artery extracranial stenosis.The more serious the illness and the lower MV on the ipsilateral,the higher the probability of cerebral watershed infarction is..