老年缺血性脑血管病患者脑血管造影结果分析

目的 分析临床诊断为缺血性脑血管疾病患者的脑血管造影（DSA）结果，评估缺血性脑血管疾病行脑血管造影检查的价值。方法 对来自2个中心的临床诊断为缺血性脑血管疾病的72例老年患者进行选择性全脑血管造影。所有患者局麻后，以Seldlnger技术穿刺一侧股动脉，按常规给予全身肝素化并监测活化凝血时间（ACT），使ACT控制在250-300s之间。结果 72例患者中，DSA检出脑供血不足19例，脑梗死32例，短暂性脑缺血发作4例，总检出率为76.4％。其中61例患者同时进行动态增强磁共振血管造影（MRA），MRA显示血管狭窄15例（24．6％），DSA46例（75．4％）；两组比较，差异有统计学意义（P〈O.01）。结论 DSA检查对缺血性脑血管疾病患者的诊断具有重要价值，可以明确短暂性脑缺血和眩晕为首发症状患者的病因，有利于及时治疗。

Analysis on the DSA results of elderly patients with ischemic cerebrovascular disease

Objective To analyze the results of digial subtraction angiography (DSA) from the 72 elderly patients with ischemic cerebral artery disease and assess the value of DSA in the diagnosis of ischemic cerebrovascular disease. Methods Selective angiographies were performed in 72 elderly patients from two centers where they were clinically diagnosed as ischemic cerebrovascular disease. Seldinger techniques were used, the 5F Sheath was put into the right femoral artery after local anesthesia, intravenous heparin was regularly administered to the patients, the activated coagulation time (ACT) was monitored which was controlled between 250 seconds to 300 seconds. Results The positive diagnosis rate of DSA examination is 76. 4%. Sixty-one cases underwent MRA and DSA examination, in the MRA group 15 cases showed vascular stenosis, the positive diagnosis rate was 24. 6%, whereas in the DSA group 46 cases revealed vascular stenosis, the positive diagnosis rate was 75. 4% , there was significant difference between the two groups. Conclusions DSA is very valuable for those who were clinically diagnosed as ischemic cerebrovasular disease, and it can prove the caeses of ischemic cerebrovascular disease in patients with TIA or vertigo as the first sign and gave the treatment in time.