急性脑梗死后侧支循环建立的影响因素临床分析

Clinical analysis of the the influence factors of collateral circulation after acute cerebral infarction

目的探讨急性脑梗死后侧支循环建立的影响因素。方法收集2012年6月~2014年7月在梧州市工人医院（广西医科大学第七附属医院）神经内科住院的217例存在脑动脉狭窄或闭塞的急性脑梗死患者的临床资料,采用Binary Logistic回归方法,分析侧支循环形成的影响因素。结果 （1）共出现侧支循环开放137例（63.1%）,单纯初级侧支54例（39.4%）,单纯次级侧支45例（32.8%）,初、次级侧支联合开放38例（27.7%）,其中前循环动脉病变158例患者有侧支开放108例（68.4%）,后循环动脉病变59例患者有侧支开放29例（48.6%）。（2）不同程度的脑动脉狭窄对侧支循环形成的影响比较差异有统计学意义（P〈0.05）。（3）无侧支循环组吸烟史发生率（58.9%）明显高于有侧支循环组（40.5%）,比较差异有统计学意义（P〈0.05）;有侧支循环组收缩压明显高于无侧支循环组,比较差异有统计学意义（P〈0.05）;其它的影响因素两组比较均无统计学意义（P均〉0.05）。结论 （1）侧支循环建立以一级侧支循环为主,其中前循环侧支开放较后循环几率大,脑动脉狭窄程度越重,侧支循环开放的几率越大;（2）脑卒中危险因素吸烟和收缩压可影响侧支循环的建立。

Objective The aim of our study is to investigate the the influence factors of collateral circulation after acute cerebral infarction. Methods 217 patients during the period from June 2012 to July 2014 in the department of neurology in Hospital of Wu Zhou（ The Seventh Affiliated Hospital Of Guangxi Medical University） were enrolled in the study.Binary Logistic regression method was used to conduct the statistical analyses. Results（ 1） Establishment of collateral circulation had been found in 137cases（ 63. 1%）,in which 54 cases（ 39. 4%） had Primary primary collateral circulation,45cases（ 32. 8%） had secondary collateral circulation and 38 cases had both primary and secondary collateral circulation（ 27. 7%）. 108 cases（ 68. 4%） with collateral circulation were found in the anterior circulation vasculopathy and 29（ 48. 6%） with collateral circulation were found in the posterior circulation vasculopathy group.（ 2） Establishment of collateral circulation was affected by various degrees of cerebral artery stenosis（ P〈 0. 05）. 3. The rate of smoking in the noncollateral circulation group was higher than the collateral circulation group（ P〈 0. 05）; the collateral circulation group had a higher systolic pressure than the non-collateral circulation group（ P〈 0. 05）. between Between-group differences on other influencing factors didn＇t reach significance（ P〉 0. 05）. Conclusion（ 1） Primary collateral circulation is the main type for the Establishment establishment of collateral circulation. Anterior collateral circulation is more than posterior collateral circulation. The more severe the cerebral artery stenosis is,the higher rate the collateral circulation establishes.（ 2） Smoking and systolic blood pressure may affect the Establishment establishment of collateral circulation.