短暂性脑缺血发作的脑血管造影分析

Cerebral Angiography in Transient Ischemic Attack

目的通过全脑血管造影结果,观察短暂性脑缺血发作(transient ischemic attacks,TIA)患者脑动脉狭窄的分布特征及侧支循环情况。方法选择行全脑血管造影检查的120例TIA患者,观察分析其是否存在脑血管狭窄、狭窄程度、狭窄分布特征以及侧支代偿情况。结果造影正常者37例(30.8%),存在脑动脉狭窄或完全闭塞的患者83例(69.2%)。在83例全脑血管造影检查阳性的患者中,前循环受累47例,占56.6%;后循环受累36例,占43.4%。轻中度狭窄的侧支循环发生率(71.4%)和重度狭窄及完全闭塞的侧支循环发生率(41.3%)比较,差异有统计学意义(P<0.05)。侧支循环的代偿主要通过Willis环途径。结论脑血管狭窄是TIA的主要原因之一,侧支循环最常见的途径是Willis环途径,血管狭窄越严重则越可能建立侧支循环。

Objective To observe the distribution characteristics of cerebral artery stenosis and the status of collateral circulation in patients with transient ischemic attack （TIA） through cerebral angiography. Methods Cerebral angiography was performed in 120 patients with TIA to observe cerebrovascular stenosis, stenosis degree,stenosis distribution and collateral compensatory circulation. Results Among the 120 patients,cerebral angiography showed normal arteries in 37（30.8%）,and cere-bral artery stenosis or occlusion in 83 （69.2%）.Among the 83 patients, anterior circulation dysfunction occurred in 47（56.6%）,and posterior circulation dysfunction in 36（43.4%）. The incidence of collateral circulation following mild-to-moderate stenosis was significantly higher than that following severe stenosis and occlusion（71.4% vs 41.3%,P〈0.05）. The circle of Willis was the main collateral pathway. Conclusion Cerebrovascular stenosis is one of the main causes of TIA and the circle of Willis is the most common pathway of collateral circulation. The more serious vascular stenosis is more likely to establish collateral circulation.