颈内动脉颅外段狭窄或闭塞患者大脑中动脉血流速度与病情及分水岭梗死的关系

Relationship between velocity of middle cerebral artery,severity of disease and watershed infarction in patients with extracranial internal carotid artery stenosis or occlusion

目的研究颈内动脉颅外段(EICA)狭窄或闭塞患者大脑中动脉(MCA)平均血流速度(MV)与病情和分水岭梗死的关系。方法对120例EICA严重狭窄或闭塞的缺血性脑血管病患者,用经颅多普勒检查仪检测同侧MCA的MV,以及进行美国国立卫生研究院卒中量表(NIHSS)评分,并经头颅CT、MRI检查确定分水岭梗死。结果MCA MV重度降低组10例,MV中度降低组38例,MV轻度降低组42例,MV正常组30例;4组NIHSS评分(分别为12.5±4.7、3.9±4.8、3.2±4.7、2.4±4.9)的差异有统计学意义(P<0.01);发生分水岭梗死的比率分别为40%、63%、38%、27%,4组差异有统计学意义(P<0.05),MV中度降低组显著高于其他3组。结论EICA严重狭窄或闭塞时,患侧MCA的MV越低,病情越重,发生分水岭梗死的比率亦高。

Objective To study the relationship between velocity of middle cerebral artery（ MCA）, severity of disease and watershed infarction （WSI） in patients with extracranial internal carotid artery （EICA） stenosis or occlusion. Methods Transcranial Doppler （TCD） was used to detect the mean velocity （MV） of MCA in 120 patients with EICA stenosis or occlusion. The National Institutes of Health Stroke Scale （NIHSS） was used to evaluated the patients＇ condition. And CT or MRI was used to diagnosised the WSI. Results MV of MCA was severe reduced in 10 cases, middle reduced in 38 cases, and mild reduced in 42 cases, while there were 30 cases with normal MV. The scores of NIHSS in the four groups （12.5±4.7, 3.9±4.8,3.2±4.7,2.4±4.9 respectively） had significant different （ P〈 0.01 ）. The incidence of WSI in the four groups were 40% , 63% , 38% , 27% respectively, the different was significant （ P 〈 0.05 ）. The incidence of WSI in the MV middle reduced group was significantly higher than those in the other groups. Conclusion The lower MV in MCA with severer EICA stenosis or occlusion, the disease condition is more severity, the incidence of WSI is also high.