大脑中动脉狭窄患者侧枝循环开放相关因素分析及其对预后的影响

目的 评估大脑中动脉患者的侧枝循环状况,进一步探讨大脑中动脉狭窄患者的相关影响因素及其对预后的影响.方法 选择住院患者经头颅磁共振成像（MRI）及磁共振血管成像（MRA）确诊的单侧大脑中动脉中-重度狭窄（其为责任血管）的急性脑梗死患者60例,采用经颅多普勒（TCD）评估侧枝循环,分为侧枝循环开放组及未开放组各30例,对患者的相关影响因素及NIHSS评分进行相关性分析.结果 大脑中动脉狭窄的急性脑梗死患者侧枝循环开放组与未开放组卒中量表（NIHSS）评分差异有统计学意义（P＜0.05）;其侧枝循环开放情况与冠心病、年龄、糖尿病、吸烟、饮酒无相关性（P＞0.05）,而与高血压病、高脂血症、高同型半胱氨酸血症及性别有相关性（OR =0.145、0.226、6.507、4.164,P＜0.05）.结论 大脑中动脉狭窄患者侧枝循环的建立与开放及多种缺血性脑血管病的危险因素有一定相关性.

Effects on the prognosis and collateral circulation condition in patients with middle cerebral artery stenosis

Objective To evaluate the collateral circulation condition of middle cerebral artery in patients,and to further explore the relate factors and their influence on the prognosis in middle cerebral artery stenosis. Methods The collateral circulation in 60 acute cerebral infarction patients with middle - severe stenosis of unilateral middle cerebral artery diagnosed by brain magnetic resonance ima- ging （MRI） and magnetic resonance angiography （MRA） was assessed using transcranial Doppler （TCD）. The collateral circulation open group with 30 patients and not open group with 30 patients were enrolled to analysis the relate factors and NIHSS score. Results The NIHSS scores of acute cerebral infarction patients with middle cerebral artery stenosis in open group and not open group were collateral circulation statistically significant （ P 〈 0.05 ）. The collateral circulation open or not had no correlation with coronary heart disease, age, diabetes, smoking, drinking （ P 〉 0.05 ）, but did with hypertension, hyperlipidemia, high homocysteine levels, and gender （OR = 0. 145,0. 226,6. 507 and 0.226 ,P 〈 0.05 ）. Conclusion There are a certain relevance in establishment and open of collateral circulation with a variety of ischemic cerebrovascular disease risk factors in middle cerebral artery stenosis.