短暂性脑缺血发作与脑动脉狭窄的脑血管造影研究

Cerebral angiographic analysis of patients with transient ischemic attack and cerebral artery stenosis

目的探讨TIA与颅内外血管狭窄的关系,研究DSA对短暂性脑缺血发作(TIA)血管病变的诊断价值。方法选择符合TIA诊断标准的患者54例行颈部血管B超、经颅多普勒(TCD)、心脏超声以及DSA检查,观察TIA患者颈内动脉和椎动脉颅内、外血管有无狭窄及粥样硬化斑块。结果54例患者中发现46例有血管狭窄,其中颈总动脉狭窄2例,颈内动脉狭窄13例,大脑中动脉狭窄5例,锁骨下动脉狭窄3例,椎动脉狭窄18例,基底动脉狭窄5例。狭窄部位斑块31例。其中大动脉狭窄性TIA 36例,栓塞性TIA 13例,腔隙性TIA 3例,血管痉挛性TIA 2例。结论TIA患者大多存在颅内外动脉狭窄及粥样硬化斑块,颅内外动脉狭窄程度及粥样硬化斑块稳定性决定TIA类型。

Objective To investigate the relationship between transient isehemic attack （TIA）and intracranial or extracranial artery stenosis. To explore the values of digital subtraction angiography （DSA） in etiological dignosis and the cerebral-vascular pathology base in the patients with transientis ischemic attack （TIA）. Methods DSA was performed to investigate the state of inter carotid artery vertebral artery in 54 patients meeting the diagnostic criterion of TIA after examinations of B ultrasound of neck, transcranial color Doppler （TCD） and cardiac ultrasound. Results Forty-six cases were found artery stenosis in 54 TIA patients. Among them, 2 cases with common carotid artery stenosis, 13 cases with internal carotid artery stenosis, 5 cases with middle cerebral artery stenosis, 3 cases with subclavian artery stenosis, 18 cases with vertebral artery stenosis, 5 cases with basilar artery stenosis. Thirty-one cases with plaques in the stenosis were found. 36 cases with TIA were related to stenosis of large arteties, 13 cases were embotic TIA,3 cases were lacunar TIA,2 cases related to vascular spasm. Conclusion Most patients with TIA have cerebral artery stenosis and sclerosis plaque. There is a positive correlation between TIA and intracranial or extracranial artery stenosis and sclerosis plaque.