脑动脉闭塞后颅内侧支循环建立与梗死灶数量的相关性分析

Correlation analysis of collateral circulation and clinical locations in patients with ischemic stroke

目的 研究缺血性脑血管病患者脑动脉闭塞时侧支循环建立的数量与梗死灶数量的关系.方法 回顾性分析2009年4月至2010年4月在首都医科大学宣武医院神经内科住院的25例缺血性脑血管病患者,经头颅磁共振成像和脑血管造影检查明确梗死灶数量和侧支循环建立的数量.利用SPSS11.5软件对所得数据进行x2检验,比较侧支循环建立的数量与病变部位数量的关系.结果 （1）25例患者,单条血管闭塞10例,多条血管闭塞15例,共有46条血管闭塞;（2）在46条闭塞血管中,23条血管有单侧支循环代偿,其中8条存在单部位病灶,15条存在多部位病灶;23条血管有多侧支循环代偿,其中18条存在单部位病灶,5条存在多部位病灶.（3）单侧支代偿血管组,多部位病灶的发生率为65.2%,多侧支代偿血管组多部位病灶发生率为21.7%,单侧支代偿血管组多部位梗死发生率明显高于多侧支代偿血管组,二者相比差异有统计学意义（P＜0.05）.结论 有效的侧支循环建立,除了Willis环的完整性之外,还和侧支循环建立的数量有关,本研究表明,多侧支循环建立,可显著减少梗死灶数目.

Objective To study the correlation of compensation by collateral circulation and clinical locations in ischemic stroke cases. Methods A total of 25 ischemic stroke cases were retrospectively analyzed. MRI （magnetic resonance imaging） and DSA （digital subtraction angiography） were performed in all cases. Each patient was found to have at least one cerebral artery occlusion by DSA. The quantity relationship between collateral circulation and ischemic stroke location was analyzed by SPSS 11.5 statistics software. Results Among all cases, 46 arterial occlusions were found by chance. DSA demonstrated internal carotid artery occlusion （n = 24） and vertebral ＆ basilar artery occlusion （n = 22）. And all cases had at least one collateral circulation. Among 23 cases of single collateral circulation, there were 8 cases of single ischemic stroke locations and 15 cases of multiple ischemic stroke locations; among 23 cases of multiple collateral circulations, there were 18 cases of single ischemic stroke locations and 5 cases of multiple ischemic stroke locations. Conclusion Effective collateral circulation can be established spontaneously through multiple ways when cerebral artery occlusion takes place if an intact Wills circle is present. Multiple collateral circulations may significantly decrease the quantity of ischemic stroke locations.