| 杨华
，王鑫丽
，李雪玮
，王彬
，陈菲
，王炎强.责任性单侧大脑中动脉重度狭窄患者脑梗死分型与侧支循环关系探讨[J].神经损伤功能重建,2020,15(12):706-709 |
| 责任性单侧大脑中动脉重度狭窄患者脑梗死分型与侧支循环关系探讨 |
| Relationship between Collateral Circulation and Ischemic Patterns of Ischemic Stroke withUnilateral Severe Symptomatic Middle Cerebral Artery Stenosis |
| |
| DOI： |
| 中文关键词: 缺血性卒中 责任性单侧大脑中动脉重度狭窄 梗死分型 侧支循环 |
| 英文关键词: ischemic stroke unilateral severe symptomatic middle cerebral artery stenosis ischemic patterns collateral circulation |
| 基金项目:山东省中医药科技
发展计划项目（No.
2017-223，2019-04
23）；
潍坊医学院科技扶
贫专项（No. FP180
1004）；
国家自然科学基金
（No.81870943） |
|
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| 中文摘要: |
| 目的：探讨责任性单侧大脑中动脉（MCA）重度狭窄致首发缺血性卒中的梗死分型与侧支循环的关
系。方法：回顾性分析187例责任性单侧MCA重度狭窄引起首发脑梗死患者的临床资料。根据侧支循环
状况分为代偿良好组79例和代偿较差组108例，比较2组的神经功能评分，分析2组脑梗死分型及其与侧支
循环的关系。结果：代偿良好组入院时美国国立卫生研究院卒中量表（NIHSS）评分和早期神经功能恶化发
生率均低于代偿较差组（均P＜0.05）。脑梗死分型结果显示，代偿良好组以皮质下小梗死最多，代偿较差组
以内分水岭梗死和多发梗死最多，2组梗死类型差异有统计学意义（P＜0.05）。脑灌注参数分析结果显示，
代偿良好组患侧达峰时间（TTP）、脑血容量（CBV）和平均通过时间（MTT）高于健侧（P＜0.05）；代偿较差组
患侧TPP、脑血流量（CBF）高于健侧，MTT低于健侧（P＜0.05）；代偿良好组脑灌注患健比rCBV、rMTT高于
代偿较差组，而rTTP、rCBF低于代偿较差组（P＜0.05）。结论：侧支循环有助于维持责任性单侧MCA重度
狭窄致首发缺血性卒中的脑灌注，改善梗死分型的构成，减少神经功能恶化发生，改善神经功能评分。 |
| 英文摘要: |
| To evaluate the relationship between collateral circulation and ischemic patterns of ischemic stroke with unilateral severe symptomatic middle cerebral artery stenosis. Methods: We retrospectively investigated 187 patients who suffered of ischemic stroke with unilateral severe symptomatic unilateral middle cerebral artery (MCA) stenosis. They were divided according to status of collateral circulation into the good collateral circulation group (n=79) and poor collateral circulation group (n=108). The neurological functions of the 2
groups were compared, and the ischemic patterns and its relationship with collateral circulations in the 2 groups
were analyzed. Results: Compared to the poor collateral circulation group, the good collateral circulation group
showed a lower NIH Stroke Scale (NIHSS) score and incidence of early deterioration of neurological function
(both P<0.05). The good collateral circulation group presented mostly small subcortical infarctions and the poor
collateral circulation group mostly internal border zone infarctions and multiple infarctions. The differences in
the ischemic patterns of the 2 groups were statistically significant (P<0.05). Analysis of cerebral perfusion parameters showed that, in the good collateral circulation group, the time to peak (TTP), cerebral blood volume
(CBV), and mean transit time (MTT) in the affected side were greater than those in the healthy side (P<0.05). In
the poor collateral circulation group, the TTP and cerebral blood flow (CBF) in the affected side were greater
than those in the healthy side, and the MTT was lower than that in the healthy side (P<0.05). In the good collateral circulation group, the relative CBV (rCBV) and rMTT of the affected side were higher than those in the poor
collateral circulation group, while rTTP and rCBF were lower than those in the poor collateral circulation group
(P<0.05). Conclusion: Collateral circulation is helpful in maintaining the cerebral perfusion in ischemic stroke
caused by severe symptomatic unilateral MCA stenosis, improving the composition of infarct patterns, reducing
the occurrence of early neurologic deterioration, and improving neurological function scores. |
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