【摘要】：目的：探討頸內(nèi)動(dòng)脈重度狹窄或閉塞的缺血性腦卒中患者其側(cè)支循環(huán)與臨床癥狀的關(guān)系。 方法：對(duì)110例單側(cè)頸內(nèi)動(dòng)脈(ICA)重度狹窄或閉塞的急性缺血性腦卒中患者,行經(jīng)顱多普勒(transcranial doppler ultrasonography, TCD)檢查,了解側(cè)支循環(huán)開(kāi)放情況。根據(jù)TCD檢測(cè)到的前交通動(dòng)脈(ACOA).后交通動(dòng)脈(PCOA)、眼動(dòng)脈(OA)的代償情況,將患者分為單純ACOA開(kāi)放組、單純PCOA開(kāi)放組、單純OA開(kāi)放組、ACOA合并PCOA開(kāi)放組及無(wú)側(cè)支循環(huán)開(kāi)放組5組,比較各組入院時(shí)和住院2周時(shí)美國(guó)國(guó)立衛(wèi)生研究院卒中量表(NIHSS)評(píng)分,以及入院時(shí)和6個(gè)月時(shí)改良Rankin評(píng)分(mRS)。 結(jié)果：(1)110例患者中ACOA開(kāi)放47例,占全部患者的43%。PCOA開(kāi)放38例,占35%；OA開(kāi)放28例,占25%。(2)無(wú)側(cè)支循環(huán)開(kāi)放組治療前后NIHSS評(píng)分、mRS評(píng)分無(wú)明顯差異(P0.05)。(3)治療2周時(shí),ACOA開(kāi)放組、PCOA開(kāi)放組、ACOA合并PCOA開(kāi)放組NIHSS評(píng)分較OA開(kāi)放組、無(wú)側(cè)支循環(huán)代償組明顯降低(P0.05)。(3)ACOA合并PCOA開(kāi)放組NIHSS評(píng)分明顯低于單純ACOA組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(4)6個(gè)月隨訪時(shí)ACOA開(kāi)放組、PCOA開(kāi)放組、ACOA合并PCOA開(kāi)放組mRS評(píng)分明顯低于OA開(kāi)放組和無(wú)側(cè)支循環(huán)代償組(P0.05)。 結(jié)論：?jiǎn)蝹?cè)頸內(nèi)動(dòng)脈重度狹窄或閉塞的缺血性腦卒中患者,前交通動(dòng)脈開(kāi)放是顱內(nèi)側(cè)支循環(huán)開(kāi)放的主要途徑,Willis環(huán)側(cè)支開(kāi)放類型與臨床癥狀、預(yù)后密切相關(guān)。
[Abstract]:Objective: to investigate the relationship between collateral circulation and clinical symptoms in ischemic stroke patients with severe stenosis or occlusion of internal carotid artery. Methods: Transcranial Doppler (transcranial doppler ultrasonography, TCD) examination was performed in 110 patients with acute ischemic stroke with severe stenosis or occlusion of unilateral internal carotid artery (ICA). (ACOA). Of anterior communicating artery detected by TCD The (OA) compensation of posterior communicating artery (PCOA),) ophthalmic artery was divided into five groups: ACOA open group, PCOA open group, OA open group combined with PCOA open group and open collateral circulation group. The (NIHSS) score of the National Institutes of Health Stroke scale at admission and 2 weeks after hospitalization, and the modified Rankin score (mRS). At admission and 6 months were compared among the groups. Results: (1) among the 110 patients, 47 cases were open to ACOA, 38 cases were open to 43%.PCOA, and 28 cases were open to 35 cases of OA. (2) there was no significant difference in NIHSS score and Mrs score before and after treatment in the open group without collateral circulation (P0.05). (3). At 2 weeks after treatment, the NIHSS score of the open group with PCOA in the open group was higher than that in the open group of OA. The score of NIHSS in ACOA combined with open PCOA group was significantly lower than that in simple ACOA group (P0.05). (3). The difference was statistically significant (P0.05). (4) after 6 months follow-up, the mRS score of ACOA open group was significantly lower than that of OA open group and non-collateral circulation compensatory group (P0.05). Conclusion: in ischemic stroke patients with severe stenosis or occlusion of unilateral internal carotid artery, open anterior communicating artery is the main way to open intracranial collateral circulation. The type of open collateral of Willis is closely related to clinical symptoms and prognosis.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R743.3

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