中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2011年
11期
766-768
,共3页
刘新通%王伟%王丽娟%何池忠%卢海克%李昌茂%张雄%代成波%王硕%马桂贤%杨哲贤%马腾云
劉新通%王偉%王麗娟%何池忠%盧海剋%李昌茂%張雄%代成波%王碩%馬桂賢%楊哲賢%馬騰雲
류신통%왕위%왕려연%하지충%로해극%리창무%장웅%대성파%왕석%마계현%양철현%마등운
血管造影数字减影术%脑梗死%侧支循环%预后
血管造影數字減影術%腦梗死%側支循環%預後
혈관조영수자감영술%뇌경사%측지순배%예후
Angiogram digital subtraction%Cerebral infarction%Collateral circulation%Prognosis
目的 通过数字减影全脑血管造影评估急性脑梗死患者侧支循环的建立情况,并探讨其与患者临床病情和预后的关系.方法 以2007年1月至2009年12月广东省人民医院神经科260例首次发病的急性脑梗死(病程1周内)的住院患者为研究对象,在发病一周内完成全脑血管造影检查,采用NIHSS评分评估入院时病情,采用改良Rankin评分评估患者3个月时的预后.结果 260例中有86例患者的罪犯血管是颅内、外大血管严重狭窄或闭塞,其中48例为前循环病变,出现侧支代偿36例(75.00%).38例为后循环病变,出现侧支代偿11例(28.64%),前者明显高于后者(P＜0.001);有侧支代偿组入院时的NIHSS评分显著低于无侧支代偿组(P＜0.001),有侧支代偿组随访3个月时改良的Rankin评分≤2分的患者的比例显著多于无代偿组(P＜0.0001).结论 对于颅内或颈部动脉严重狭窄或闭塞所致的急性脑梗死患者,通过DSA能准确评估患者的侧支循环的建立与否,从而判断预后,有侧支循环患者的预后明显优于无侧支循环患者.
目的 通過數字減影全腦血管造影評估急性腦梗死患者側支循環的建立情況,併探討其與患者臨床病情和預後的關繫.方法 以2007年1月至2009年12月廣東省人民醫院神經科260例首次髮病的急性腦梗死(病程1週內)的住院患者為研究對象,在髮病一週內完成全腦血管造影檢查,採用NIHSS評分評估入院時病情,採用改良Rankin評分評估患者3箇月時的預後.結果 260例中有86例患者的罪犯血管是顱內、外大血管嚴重狹窄或閉塞,其中48例為前循環病變,齣現側支代償36例(75.00%).38例為後循環病變,齣現側支代償11例(28.64%),前者明顯高于後者(P＜0.001);有側支代償組入院時的NIHSS評分顯著低于無側支代償組(P＜0.001),有側支代償組隨訪3箇月時改良的Rankin評分≤2分的患者的比例顯著多于無代償組(P＜0.0001).結論 對于顱內或頸部動脈嚴重狹窄或閉塞所緻的急性腦梗死患者,通過DSA能準確評估患者的側支循環的建立與否,從而判斷預後,有側支循環患者的預後明顯優于無側支循環患者.
목적 통과수자감영전뇌혈관조영평고급성뇌경사환자측지순배적건립정황,병탐토기여환자림상병정화예후적관계.방법 이2007년1월지2009년12월광동성인민의원신경과260례수차발병적급성뇌경사(병정1주내)적주원환자위연구대상,재발병일주내완성전뇌혈관조영검사,채용NIHSS평분평고입원시병정,채용개량Rankin평분평고환자3개월시적예후.결과 260례중유86례환자적죄범혈관시로내、외대혈관엄중협착혹폐새,기중48례위전순배병변,출현측지대상36례(75.00%).38례위후순배병변,출현측지대상11례(28.64%),전자명현고우후자(P＜0.001);유측지대상조입원시적NIHSS평분현저저우무측지대상조(P＜0.001),유측지대상조수방3개월시개량적Rankin평분≤2분적환자적비례현저다우무대상조(P＜0.0001).결론 대우로내혹경부동맥엄중협착혹폐새소치적급성뇌경사환자,통과DSA능준학평고환자적측지순배적건립여부,종이판단예후,유측지순배환자적예후명현우우무측지순배환자.
Objective To evaluate the correlation of collateral circulation with prognosis in patients with acute cerebral infarction.Methods A total of 260 patients with acute ischemie stroke within 1 week of symptom onset underwent digital subtraction angiogram (DSA).The National Institutes of Health Stroke Scale (NIHSS) scores were obtained at admission.And the Modified Rankin scores (mRS) were assessed at a 3-month follow-up.The follow-up data were acquired through clinic visits or telephone interviews.Results Among them,86 were found to have intra- or extra-cranial culprit artery severe stenosis or occlusion.And 36(75.00%) in 48 patients had collateral arterial circulation while 11 (28.64%)in 38 patients posterior circulation.There were statistical differences in the NIHSS scores at admission and favorite clinical outcome (mRS≤2) at 3-month follow-up for patients with and without collateral circulation.Conclusion DSA is the golden standard for the assessment of collateral circulation in patients with severe cerebral artery stenosis or occlusion.The prognosis is better in stroke patients with collateral circulation.
