大脑中动脉慢性闭塞患者颅内血流动力学与缺血性脑血管病的相关性研究

目的探讨大脑中动脉（MCA）慢性闭塞颅内血流动力学与缺血性脑血管病的相关性。方法选取单侧MCA慢性闭塞患者65例为闭塞组，分为脑梗死组、短暂性脑缺血发作（TIA）组和无体征组。经颅多普勒（TCD）检测双侧大脑前动脉（ACA）、大脑后动脉（PCA）峰流速，计算其比值（RVACA、RVPCA），并与健康组进行比较。闭塞组根据NIHSS分组，分析RVACA、RVPCA与NIHSS之间的相关性。结果闭塞组ACA、PCA流速及RVACA明显高于健康组（P〈0．05）；无体征组、TIA组RVPCA较健康组高（P〈0．05）；闭塞组RVACA、RVPCA与NIHSS呈负相关（P〈0．01）。结论皮质软脑膜侧支吻合血管开放是MCA闭塞代偿的重要途径，其代偿程度与脑缺血预后密切相关。

Study on relationship between hemodynamic changes and ischemic cere- brovasculardiseaseinpatientswithmiddlecerebral artery chronicocclusion

Objective To investigate the relationship between hemodynamic changes and ischemic cerebrovascular dis- ease in patients with middle cerebral artery （MCA） chronic occlusion. Methods A total of 65 patients with unilateral MCA occlusion confirmed were selected,which were divided into stroke group,transient ischemic attacks（TIA） group and asymptomatic ：group. Through the examination of transcranial Doppler （TCD）, the ratio of bilateral anterior cere- bral artery （RVACA） flow velocity and the ratio of bilateral posterior cerebral artery （RVPCA） flow velocity were cal- culated in patients with the unilateral MCA occlusion, compared with the healthy controls. The occlusion patients were divided into five groups according to NIHSS ,which RVACA,RVPCA were compared. Results RVACA and the systolie velocity of ACA/PCA in occlusion groups were significantly higher than that in healthy controls.RVPCA in TIA groups and asymptomatic groups was significantly higher than ratios of healthy controls （P 〈 0.05）. There was an negative correlation between the RVACA and the NIHSS in occlusion group,and the same to RVPCA. Conclusion The opening of leptomeningeal anastomoses vessel is the important way of collateral circulation in the cases of occlu- sion of MCA,which is closely associated with prognosis of cerebral infarction patients.