大脑中动脉供血区脑梗死侧支循环与预后的相关性研究

Relationship Between Collateral Circulation and Neurologic Impairment in Patients with Cerebral Infarction of MCA Territory

目的:探讨大脑中动脉(MCA)供血区脑梗死侧支循环与预后的相关性。方法:选择96例大脑中动脉供血区脑梗死病人(病例组),发病7d内进行经颅多普勒(TCD)检查,并且于入院第1天及发病后90d进行美国国立卫生研究院卒中量表(NIHSS)评分。结果:TCD检查结果表明:70例病人存在大脑前动脉(ACA)代偿,42例病人存在大脑后动脉(PCA)代偿,30例病人同时存在ACA代偿和PCA代偿。病例组两侧动脉收缩期峰值流速比值(RVACA)较正常对照组显著升高(P<0.01);MCA主干脑梗死和皮层支脑梗死病人的两侧动脉收缩期峰值流速比值显著较对照组及深穿支梗死组高(P<0.01或<0.05)。结论:MCA皮质软脑膜侧支吻合血管开放是大脑中动脉供血区脑梗死侧支循环的主要途径,侧支循环状况好的病人病情较侧支循环差的病人轻,预后良好。

Objective： To study I,he relation between collateral circulation and neurologic imparement in patients with cerebral infarction of MCA territory. Methods：96 patients with cerebral infarction of MCA territory were examined by transcranial Doppler （TCD）. The National Institutes of Health Stroke Scale（NIHSS） was used to investigate the de- gree of nervous functional defects of all the patients admission day and at 90 days after onset. Results.TCD showed that 70 cases were compensated by ACA, 42 cases compensated by PCA, and 30 cases were compensated by both ACA and PCA. RVACA in the patient group was significantly higher than that on controls（P〈0. 01） ;RVACA in the patien with stem and cortex infarction was high than those of control（P〈0. 01 or P〈0. 05）. Conclusion： The opening of leptomen- ingeal anastomoses vessel is the important way of collateral circulation in cases of patients with cerebral infarction of MCA territory, the disease condition and prognosis in patients with enough collateral circulation are comparatively bet- ter.