脑动脉狭窄或闭塞后侧支循环与卒中预后的关系

The Relationship of Collateral Circulation and Prognosis in Patients with Intracranial or Cervical Artery Stenosis or Occlusion

目的:通过经颅多普勒超声(TCD)评估急性缺血性卒中患者颅内外血管狭窄或闭塞时的侧支循环建立情况,并探讨其与患者预后的关系。方法:通过TCD检查115例首次急性缺血性卒中患者的脑血流动力学,发现大脑中动脉狭窄或闭塞20例,颈内动脉颅外段狭窄或闭塞12例,椎动脉起始部闭塞5例。检查这37例患者侧支循环建立情况,并记录患者入院时、出院时、发病3个月(随访时)NIHSS评分和出院时、随访时mRS评分。结果:有侧支循环者出院时NIHSS评分、随访时NIHSS评分和mRS评分均较无侧支循环者低(P<0.05)。结论:对于颅内或颈部主干动脉狭窄或闭塞患者,TCD评估侧支循环建立能评估预后,有侧支循环者预后明显优于无侧支循环者。

Objective： The correlation of collateral circulation with prognosis in patients with cerebra artery stenosis or occlusion has been observed. Methods： One hundred and fifteen patients with acute ischemic strokes were examined by TCD. The collateral circulations were evaluated in patients with cerebral artery stenosis or occlusion. A neurologist documented the patients＇ NIHSS scores at admission, discharge, and three months later, as well as mRS scores at discharge and three months later. Results： Out of the patients, 20 cases were found to have middle cerebral artery stenosis or occlusion, and 12 cases to have stenosis or occlusion of extracranial portion of the internal carotid arteries. There were statistical differences of the NIHSS scores at discharge, the scores of NIHSS and mRS three months later of patients with and without collateral circulation. Conclusion：The prognosis of patients with cerebral artery stenosis or occlusion could be predicted by the formation of the collateral circulation, which could be assessed by TCD.