CAJ | 학술논문

目的：探讨缺血性脑血管病（ ICVD）患者血管病变在全脑血管造影术（ DSA）的分布及伴随疾病情况，并观察并发症，以及DSA在ICVD中的价值。方法回顾性分析99例ICVD患者的DSA资料，按缺血类型分为脑梗死（CI）组和短暂性脑缺血发作（TIA）组。所有患者经头颅3D-TOF和颈部血管彩超筛选，经DSA检查最后诊断。同时观察围手术期并发症以及伴随疾病情况。结果99例ICVD患者中，88例经DSA检查确诊存在血管病变。99例患者共存在252处病变，占前三位的为颈内动脉（ ICA）、椎动脉（ VA）以及大脑中动脉（ MCA）。同时共存在121处分叉部病变，占前三位的为ICA、VA以及颈外动脉（ ECA）。 TIA中伴随前三位疾病为高血压（HTN）、2型糖尿病（2DM）以及高脂血症和肾功能不全；CI中为HTN、2DM以及高脂血症。并发症共发生10例，最多的为血管迷走神经反射5例；严重的为TIA和CI各1例（出院时未造成任何神经功能缺损）。结论颈动脉系统血管病变在ICVD发生中起重要作用，尤其在血管分叉部易出现病变。在ICVD发病高危因素以HTN居多，其次为2-DM、高脂血症。 DSA手术严重并发症极少，能提供更全面血管信息，为进一步制定ICVD防治方案提供依据，此检查安全、可靠。
목적：탐토결혈성뇌혈관병（ ICVD）환자혈관병변재전뇌혈관조영술（ DSA）적분포급반수질병정황，병관찰병발증，이급DSA재ICVD중적개치。방법회고성분석99례ICVD환자적DSA자료，안결혈류형분위뇌경사（CI）조화단잠성뇌결혈발작（TIA）조。소유환자경두로3D-TOF화경부혈관채초사선，경DSA검사최후진단。동시관찰위수술기병발증이급반수질병정황。결과99례ICVD환자중，88례경DSA검사학진존재혈관병변。99례환자공존재252처병변，점전삼위적위경내동맥（ ICA）、추동맥（ VA）이급대뇌중동맥（ MCA）。동시공존재121처분차부병변，점전삼위적위ICA、VA이급경외동맥（ ECA）。 TIA중반수전삼위질병위고혈압（HTN）、2형당뇨병（2DM）이급고지혈증화신공능불전；CI중위HTN、2DM이급고지혈증。병발증공발생10례，최다적위혈관미주신경반사5례；엄중적위TIA화CI각1례（출원시미조성임하신경공능결손）。결론경동맥계통혈관병변재ICVD발생중기중요작용，우기재혈관분차부역출현병변。재ICVD발병고위인소이HTN거다，기차위2-DM、고지혈증。 DSA수술엄중병발증겁소，능제공경전면혈관신식，위진일보제정ICVD방치방안제공의거，차검사안전、가고。
Objective To explore the distribution of vascular lesions in the cerebral digital subtraction angi-ography( DSA) and associated diseases in patients with ischemic cerebrovascular disease( ICVD) ,and complications, as well as the value of DSA in ICVD.Methods The DSA data of 99 ICVD cases were analyzed retrospectively, patients treated by ischemia type were divided into the cerebral infarction(CI) and transient ischemic attack(TIA) group.All patients were examined by 3D-TOF and neck vascular ultrasound screening,the final diagnosis by DSA. While observing the perioperative complications and associated diseases.Results 99 patients with ICVD,88 cases of the presence of vascular lesions diagnosed by DSA.In 99 cases,there were 252 lesions,accounting for the top three for the internal carotid artery(ICA),vertebral artery(VA) and the middle cerebral artery(MCA).While there were 121 bifurcation lesions,accounting for the top three for ICA,VA,and the external carotid artery(ECA).TIA in patients with concomitant diseases accounted for the top three for hypertension(HTN),type 2 diabetes mellitus(T2DM) and hyperlipidemia and renal insufficiency;Patients with CI associated diseases accounted for the top three for HTN, T2DM and hyperlipidemia.There were 10 cases of patients with DSA complications,most of the vasovagal reflex in five cases;serious for TIA and CI in 1 case ( not cause any neurological deficits at discharge ) .Conclusion Carotid vascular disease plays an important role in the occurrence of ICVD, especially in the blood vessels of bifurcation lesion.Within ICVD risk factors in HTN in the majority, followed by T2DM, hyperlipidemia.DSA surgery rarely serious complications,blood vessels can provide more comprehensive information,and provide the basis for further development of ICVD prevention and treatment programs,this checking method is safe and reliable.