青年脑梗死患者数字减影脑血管造影评价

Analysis of young adults with cerebral infarction by digital subtration angiography

目的利用数字减影脑血管造影(DSA)方法观察青年脑梗死患者脑血管的结构异常情况,分析病变血管的程度、分布以及侧支循环的代偿情况,探讨其临床价值。方法回顾性分析我科收治并进行DSA检查的146例青年脑梗死患者的临床资料及血管学资料。结果 146例患者DSA检查存在血管异常者102例(异常率69.8%),以动脉粥样斑块、血管狭窄或闭塞为主,共255处,其中以大脑中动脉最多见。无血管危险因素患者烟雾病比例比有血管危险因素患者显著增高。重度狭窄或闭塞病变时,侧支循环发生率明显增高(P<0.05)。结论青年脑梗死DSA检查阳性率较高,动脉粥样硬化是其重要致病原因,颅内、外血管均可累及,侧支循环发生与血管狭窄的严重程度相一致。

Objective To observe the vascular structures abnormal of young adults with cerebral infarction patients by digital subtractions angiography（DSA）,and evaluate the distribution,degree of cerebral artery stenosis or occlusion and the patterns of collateral circulation.Methods 146 young adult patients with cerebral infarction who had checked by DSA were retrospectively analyzed.Results Vascular abnormalities were found in 102 patients（69.8%）,artherosclerosis stenosis or occlusion were mostly found in 255 lesions.The middle cerebral arteries were the most frequently involved in anterior circulation.The vertebral arteries were the most commonly involved in the posterior circulation.There were 11 cases of Moyamoya＇s disease in the 27 patients without risk factors.There was significant difference in the rate of incidence of collateral circulation between mild-moderate stenosis and severe-occlusive stenosis（P0.05）.Conclusion The incidence of cerebral vascular abnormal of young adults with cerebral infarction patients is high.Arteriosclerosis is one of the important factors in the process of pathogenesis.The incidence of collateral circulation is related to the severity of cerebral vascular abnormalities.