74例脑缺血性事件患者全脑血管造影分析

Cerebral angiographic findings in 74 cerebral ischemic event patients

目的分析脑缺血性事件患者全脑数字减影血管造影(DSA)的临床资料,为临床治疗提供依据。方法将74例脑缺血性事件患者,根据病因分为脑梗死组52例和短暂性脑缺血发作(TIA)组22例,行高选择性颈部及颅内DSA,观察血管狭窄部位、受累血管数目以及血管狭窄形态,并判断血管狭窄程度。结果DSA显示,脑梗死组患者有血管病变的47例(90.38%),前循环血管受累15例(31.91%),后循环血管受累8例(17.02%),前后循环同时受累24例(51.06%);单支血管受累11例(23.40%),多支血管受累36例(76.60%);TIA组患者有血管病变的18例(81.82%),前循环血管受累9例(50.00%),后循环血管受累3例(16.67%),前后循环同时受累6例(33.33%);单支血管受累8例(44.44%),多支血管受累10例(55.56%),两组比较差异无统计学意义(P>0.05)。前循环病变血管以颈内动脉和大脑中动脉为主,后循环以椎动脉为主,多部位多支血管受累常见。结论DSA对脑缺血性事件患者临床治疗的指导、选定防治方案,判断预后具有重大意义。

Objective To analyze the clinical data of cerebral digital subtraction angiography（DSA） of ischemic stroke patients. Methods Seventy-four cerebral ischemic event patients underwent highly selective DSA for observation of carotid arteries, vertebral arteries, and all intracranial arteries. The degree of stenosis, the locations and numbers of the arteries involved and the morphology of plaque or the stenosis were assessed. Results Angiography showed occlusion or stenosis of cerebral artery in 90.38% of the cerebral infarction patients,of them 31.91% were located in anterior circulation, 17.02% in posterior circulation and 51.06% in both anterior and posterior circulations. Single vessel was involved in 23. 40% and muhiplie vessels were involved in 76.60%. In transient ischemic attack patients,81.82% had vascular lesions,of them 50.00% were located in anterior circulation, 16.67% in posterior circulation and 33.33% in both anterior and posterior circulations. Single vessel was involved in 44.44% and multiple vessels were involved in 55.56 %. The internal carotid arteries and middle cerebral arteries were most frequently involved in anterior circulation and the vertebral arteries were most frequently involved in the posterior circulation. Muhiposition and multiple vessels involvement were common. Conclusion DSA can judge the prognosis and offer the evidence for formulating the plans of prevention and treatment of ischemic stroke.