摘要
目的探讨颈内动脉(internal carotid artery,ICA)重度狭窄或闭塞患者颅内侧支循环开放类型与临床表现之间的关系。方法经数字减影血管造影(digital subtraction angiography,DSA)检查证实的ICA狭窄或闭塞患者78例,根据临床有无脑缺血症状和神经系统定位体征分为无症状组31例和有症状组47例,行经颅多普勒超声(transcranial doppler ultrasonography,TCD)检测患者侧支循环开放情况及大脑中动脉的平均血流速度(MVMCA)。经统计学分析颅内侧支循环类型与临床表现的相关性。结果①78例颈内动脉重度狭窄或闭塞患者侧支循环开放率为70.5%(55/78),无症状组87.1%(27/31)高于有症状组59.6%(28/47)(P<0.01);②无症状组的前交通动脉(anterior communicating artery,ACoA)开放率77.4%(24/31)明显高于有症状组42.6%(20/47)(P<0.01),有症状组眼动脉(ophthalmic artery,OA)侧支开放率44.7%(21/47)明显高于无症状组19.4%(6/31)(P<0.05);无症状组中ACoA开放率77.4%明显高于后交通动脉(posterior communication arteries,PCoA)、OA侧支开放(P<0.05);③无症状组病变侧大脑中动脉MVMCA51.58±12.36cm/s明显高于有症状组32.23±10.31 cm/s(P<0.01)。结论颈内动脉重度狭窄或闭塞患者Willis动脉环侧支开放与临床表现密切相关,颅内侧支循环以Willis环的前交通开放为主。
Objective To explore the relationship between collateral circulation and clinical manifestation after severe stenosis or occlusion of internal carotid artery. Methods According to the clinical manifestation, 78 cases of ICA stenosis or occlusion confirmed by digital subtraction angiography （DSA） were divided into two groups： asymptomatic group （n=31） and symptomatic group （n=47）. Collateral circulation pathway in circle of Willis and the mean flow velocity of the middle cerebral arteries （MVMcA） were measured by Transcranial Doppler Uhrasonography （TCD）. The correlation of the types of intracranial collateral circulation and clinical manifestation was analyzed. Results ① The collateral circulation opening rate of severe stenosis or occlusion of internal carotid artery in 78 cases of patients was 70.5% （55/78）. The collateral patency rate （27/31, 87.1% of patients） was higher in asymptomatic group than in the symptomatic group （28/ 47, 59.6% of patients）（P 〈0.01）. ② Collateral patency of anterior communicating artery （ACoA）in asymptomatic group （24/31, 77.4% of patients） was higher than that in symptomatic group （20/47, 42.6% of patients） （P〈0.01）. Collateral patency of ophthalmic artery （OA） in symptomatic group （21/47, 44.7% of patients） was higher than that in asymptomatic group（6/31, 19.4% of patients）（P〈0.05）. The opening rate of ACoA was significantly higher than that of either the posterior communicating artery （PCoA） or OA collateral circulation in asymptomatie group （P〈0.05）. ③ The mean flow velocity of the affected side middle cerebral arteries （MVMCA） in asymptomatic group （51.58±12.36cm/s） was significantly higher than that in symptomatic group （32.23± 10.31cm/s） （P〈0.01）. Conclusion The clinical manifestation is closely related to arterial circle of Willis collateral circulation opening after severe stenosis or occlusion of internal carotid artery and collateral patency of anterior communicating artery is the major collateral supply vessel.
出处
《中国神经精神疾病杂志》
CAS
CSCD
北大核心
2013年第11期658-661,共4页
Chinese Journal of Nervous and Mental Diseases
关键词
颈动脉狭窄
侧支循环
超声检查
经颅
多普勒
Carotid Stenosis Collateral Circulation Uhrasonography Transcranial Doppler
