中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2010年
5期
513-515
,共3页
颈动脉重度狭窄%数字减影血管造影%侧支循环%临床结局
頸動脈重度狹窄%數字減影血管造影%側支循環%臨床結跼
경동맥중도협착%수자감영혈관조영%측지순배%림상결국
Severe stenosis of internal carotid artery%Digiul subtract angiography%Collateral circulatior%Clinical outcome
目的 应用数字减影血管造影(DSA)研究颈内动脉重度狭窄患者侧支循环开放途径和程度,并观察其对患者临床结局的影响.方法 经全脑DSA检查证实存在颈内动脉重度狭窄(70%～99%)患者49例,评价其侧支循环开放的途径和程度.观察12个月后新发脑梗死、短暂脑缺血发作(TIA)或脑出血的发病情况.结果①49例患者,无侧支循环开放9例(18.4%,9/49),初级侧支循环开放39例(79.6%,39/49),次级侧支循环开放25例(51.0%,25/49).开放途径与临床结局无明显相关.②49例患者侧支开放程度0级9例(18.4%,9/49),并发症发生率44.44%(4/9),1、2级15例(30.6%,15/49),并发症发生率50.66%(8/15),3、4级25例(51.0%,25/49),并发症发生率24.00%(6/25),3、4级患者缺血性脑血管病发生率显著高于0级和1、2级患者(X2值分别为4.856、3.242,P均＜0.05).结论 颈内动脉重度狭窄时,侧支循环代偿途径与临床结局无明显相关,侧支循环程度与临床结局显著相关.
目的 應用數字減影血管造影(DSA)研究頸內動脈重度狹窄患者側支循環開放途徑和程度,併觀察其對患者臨床結跼的影響.方法 經全腦DSA檢查證實存在頸內動脈重度狹窄(70%～99%)患者49例,評價其側支循環開放的途徑和程度.觀察12箇月後新髮腦梗死、短暫腦缺血髮作(TIA)或腦齣血的髮病情況.結果①49例患者,無側支循環開放9例(18.4%,9/49),初級側支循環開放39例(79.6%,39/49),次級側支循環開放25例(51.0%,25/49).開放途徑與臨床結跼無明顯相關.②49例患者側支開放程度0級9例(18.4%,9/49),併髮癥髮生率44.44%(4/9),1、2級15例(30.6%,15/49),併髮癥髮生率50.66%(8/15),3、4級25例(51.0%,25/49),併髮癥髮生率24.00%(6/25),3、4級患者缺血性腦血管病髮生率顯著高于0級和1、2級患者(X2值分彆為4.856、3.242,P均＜0.05).結論 頸內動脈重度狹窄時,側支循環代償途徑與臨床結跼無明顯相關,側支循環程度與臨床結跼顯著相關.
목적 응용수자감영혈관조영(DSA)연구경내동맥중도협착환자측지순배개방도경화정도,병관찰기대환자림상결국적영향.방법 경전뇌DSA검사증실존재경내동맥중도협착(70%～99%)환자49례,평개기측지순배개방적도경화정도.관찰12개월후신발뇌경사、단잠뇌결혈발작(TIA)혹뇌출혈적발병정황.결과①49례환자,무측지순배개방9례(18.4%,9/49),초급측지순배개방39례(79.6%,39/49),차급측지순배개방25례(51.0%,25/49).개방도경여림상결국무명현상관.②49례환자측지개방정도0급9례(18.4%,9/49),병발증발생솔44.44%(4/9),1、2급15례(30.6%,15/49),병발증발생솔50.66%(8/15),3、4급25례(51.0%,25/49),병발증발생솔24.00%(6/25),3、4급환자결혈성뇌혈관병발생솔현저고우0급화1、2급환자(X2치분별위4.856、3.242,P균＜0.05).결론 경내동맥중도협착시,측지순배대상도경여림상결국무명현상관,측지순배정도여림상결국현저상관.
Objective To research collateral pathways and collateral grading through digital subtract angiography(DSA) and their relation to clinical prognosis.Methods Collateral pathways and collateral grading of 49 cases suffered from severe internal carotid artery (ICA) stenosis (70% -99% ) were assessed through DSA.Incidence of stroke,TIA or cerebral hemorrhage were observed in the following 12 months.Results ①In all the subjects,no collateral pathway exist in 9 cases(18.9%),and primary and secondary collateral pathways occurred in 39(79.6% ) and 25(51.0%)cases.Pathway is not related to clinical prognosis.②There were 9 ,15 and 25 cases in 0 grade,1 -2 grade and 3 -4 grade collateral circulation and the complication ratio is 44.4%,50.66% and 24.00% respectively.Incidence of ischemic cerebrovascular disease is significantly higher in 3 - 4 grade patinets than those in 0 and 1 - 2 grade pation(x2 =4.856,3.242;all P ＜ 0.05 ).Conclusions Collateral levels but not pathway were correlated with clinical prognosis in patients with severe stenosis of internal carotid artery.
