急性脑梗死患者脑侧支循环形成情况及其对梗死体积和预后的影响

THE FORMATION OF CEREBRAL COLLATERAL CIRCULATION IN PATIENTS WITH ACUTE CEREBRAL INFARCTION AND ITS EFFECT ON INFARCT VOLUME AND PROGNOSIS

目的探讨急性脑梗死患者脑侧支循环形成情况及其对梗死体积和预后的影响。方法回顾分析352例住院治疗期间行头颈部256层螺旋CT血管造影(CTA)检查的急性脑梗死患者临床资料,依据头颈部CTA影像结果观察到的侧支循环形成情况,分为有侧支循环组和无侧支循环组,分析急性脑梗死患者脑侧支循环形成情况及其与梗死体积和预后的关系。结果 (1)352例急性脑梗死患者中,有侧支循环形成197例(56.0%),无侧支循环形成者155例(44.0%)。197例有侧支循环形成患者中,前交通动脉开放74例(37.6%),后交通动脉开放53例(26.9%),软脑膜侧支建立113例(57.4%),眼动脉开放9例(4.6%),枕动脉4例(2.0%),颈升动脉4例(2.0%)。(2)有侧支循环组急性脑梗死患者的梗死灶体积明显小于无侧支循环组(Z=-2.597,P=0.009),差异有统计学意义。(3)有侧支循环形成组急性脑梗死患者的预后明显好于无侧支循环形成组(Z=-3.541,P=0.000),差异有统计学意义。结论有脑侧支循环形成的急性脑梗死患者脑梗死体积小,预后较好。

Objective To investigate the formation of cerebral collateral circulation in patients with acute cerebral infarction and its effect on infarct volume and prognosis.Methods A retrospective analysis was performed on the clinical data of 352 cases of hospitalized head and neck256 slice spiral CT angiography（CTA）examination of patients with acute cerebral infarction.According to the formation of collateral circulation in the head CTA imaging results,it was divided into collateral circulation group and none collateral circulation group,to analysis of the formation of cerebral collateral circulation in patients with acute cerebral infarction and its relationship with infarct volume and prognosis.Results In 352 cases of acute cerebral infarction patients,197 cases（56.0%）were with collaterals,155 cases（44.0%）were with none collateral.In 197 cases with collaterals,the anterior communicating artery opening 74 cases（37.6%）,the posterior communicating artery opening 53 cases（26.9%）,collateral leptomeningeal establishing 113 cases（57.4%）,ophthalmic artery opening 9 cases（4.6%）,occipital artery opening 4 cases（2.0%）,occipital artery opening 4 cases（2.0%）.The volume of acute cerebral infarction in patients with collateral circulation was significantly smaller than that in patients without collateral circulation（Z=-2.597,P=0.009）,the difference was statistically significant.The prognosis of acute cerebral infarction in patients with collateral circulation was significantly better than that in patients without collateral circulation（Z=-3.541,P=0.000）,the difference was statistically significant.Conclusion The acute cerebral infarction in patients with collateral circulation has small infarct volume,the prognosis is better.