脑梗死患者急性期全脑血管造影的临床分析

Analysis of brain angiography in patients with acute cerebral infarction

目的分析脑梗死患者急性期全脑数字减影血管造影术(DSA)的资料,探讨颅内外动脉病变的性质、程度及范围特点。方法选择脑梗死患者207例,按年龄分为老年组(≥60岁,116例)和非老年组(<60岁,91例),患者均进行主动脉弓+全脑DSA,分析血管狭窄的程度和部位及年龄变化的规律。结果 DSA显示148例(71.5%)患者共413处血管狭窄,其中颅外动脉狭窄211处(51.1%),颅内动脉狭窄202处(48.9%),颅外动脉狭窄以颈内动脉颅外段多见,颅内动脉狭窄以大脑中动脉多见。老年组患者颅内合并颅外动脉狭窄的比例46.7%,明显高于非老年组的26.7%,差异有统计学意义(P<0.05)。结论 DSA能显示脑梗死患者颅内外动脉狭窄分布的规律,有助急性脑梗死的治疗,以降低脑梗死的复发率。

Objective To analze the data of digital subtraction angiography（DSA）, including the distribution and severity of cerebral artery stenosis, in patients with acute cerebral infarction. Methods 148 of 207 patients with cerebral infarction confirmed by angiography had arterial stenosis. The characteristics of distribution of cerebral artery stenosis and the relationship between arterial stenosis and age were analyzed. Results A total of 413 sites of intra- and extra-cranial artery stenosis were found in 148 patients（71.50%,148/207）,of which,211 （51. 1%） were at extracranial arteries and 202 （48.9%） at inrtacranial arteries. Extracranial artery stenoses were most common at the extracranial segments of internal carotid artery（55.9%,118/211）, and intracranial artery stenoses were most common at the middle cerebral artery （40.1% ,81/202）. In the old-aged group（≥60 years）, the rate of coexistence of intracranial and extracrainial artery stenoses （46.7 % ） was higher than that in middle-aged group （〈 60 years, 26.7 %, P 〈0.05）. Conclusions The incidence of cerebral artery stenosis in patients with cerebral infarction is very high. DSA can show the distribution and severity of intra- and extra-cranial arterial stenoses and is helpful to treatment of acute cerebral infarction and lowering the recurrence of stroke.