急性脑梗死后侧支循环建立的特点及影响因素

目的探讨急性脑梗死患者侧支循环建立的特点及其影响因素。方法选择急性脑梗死患者242例，检测所有患者血清C反应蛋白（CRP）、纤维蛋白原（FIB）、同型半胱氨酸（HCY）、总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C），并进行脑血管数字减影血管造影检查（DSA）检查，分析侧支循环形成特点和影响因素。结果242例急性脑梗死患者中，前循环病变侧支循环开放率高于后循环病变（χ^2=16．228，P=0．000）；不同程度脑动脉狭窄患者侧支循环开放率差异有统计学意义（χ^2=9．618，P=0．000）。吸烟、糖尿病、高血压病发生率及血清HDL-C水平在有、无侧支循环患者之间差异有统计学意义（P〈0．0．5）；多因素logistic回归分析显示吸烟、高血压是影响急性脑梗死患者脑动脉侧支循环形成的危险因素，血清HDL-C水平升高是侧支循环形成的保护因素。结论急性脑梗死患者前循环病变侧支循环开放率高，随着脑动脉狭窄程度的加重侧支循环的开放率增加，吸烟和高血压可能是影响侧支循环开放的危险因素，而高HDL水平促进侧支循环的开放。

Objective To explore the specificity and influencing factors of the establishment of collateral circulation after acute cerebral infarction. Methods 242 patients with acute cerebral infarction were selected and underwent serum C reactive protein （ CRP ） , fibrinogen （ FIB ） , homocysteine （ HCY ） , total cholesterol, total cholesterol （ TC ） , three acyl glycerol （ TG ） , low density lipoprotein cholesterol （ LDL-C ） , high density lipoprotein cholesterol （ HDL-C ） , and high density lipoprotein cholesterol （ DSA ） examination. The characteristics and influencing factors of collateral circulation were analyzed. Results Anterior circulation lesions in collateral circulation rate was higher than that of the posterior circulation disease in 242 Patients with acute cerebral infarction （χ^2= 16.228, P=-0.000 ） ; There were statistically significant differences in collateral circulation rate of patients with different cerebral artery stenosis （χ^2=9.618, P=0.000 ） . There was statistically significant difference in Smoking, diabetes and hypertension occurrence rate and serum HDL-C level between the patients with collateral circulation or not （ P〈0.0.5 ） . Smoking and hypertension were risk factors to form acute cerebral infarction cerebral artery collateral circulation in patients and elevated levels of serum HDL-C was a protective factor to form collateral circulation were shown by multivariate logistic regression analysis. Conclusion Opening rate of anterior circulation lesions collateral circulation in patients with acute cerebral infarction is high, with the degree of cerebral artery stenosis increasing, the opening rate increased, smoking and high blood pressure may be risk factors for influence of collateral circulation, and high HDL levels can promote the opening of the collateral circulation.