摘要
目的探讨颅外段脑动脉狭窄程度与狭窄远近端血管内压力比的相关性。方法选择空军总医院神经内科自2015年9月至2017年2月收治的28例经DSA检查证实颅外段脑动脉狭窄率≥50%患者,采用DSA检查判断侧支循环分级情况,采用压力导丝系统测量颅外段脑动脉狭窄远近端的血管内压力并计算出压力比,采用Spearman相关性检验分析脑动脉狭窄率与压力比的相关性以及侧支循环分级与压力比的相关性。结果28例患者中共有31支狭窄颅外段脑动脉获得了完整压力测量值。31支脑动脉中,颈内动脉起始部狭窄9支,椎动脉起始部狭窄12支,锁骨下动脉近端狭窄10支。31支脑动脉的狭窄率与压力比呈负相关关系(r=-0.615,P=-0.0001,9支颈内动脉的狭窄率与压力比呈负相关关系(F=-0.948,P=-0.000),12支椎动脉的狭窄率与压力比呈负相关关系fr:=-0.757,P=-0.004),10支锁骨下动脉的狭窄率与压力比呈负相关关系(F-0.759,P=0.011)。28例患者的侧支循环分级与压力比呈负相关关系(r==-0.475,P=0.007)。结论随着颅外段脑动脉狭窄程度的增高.压力比呈现出减小的趋势;侧支循环也是影响脑动脉狭窄后压力比的重要因素。
Objective To observe the correlation between degrees ofextracranial cerebral artery stenosis and pressure ratio across stenosis. Methods The patients with 〉 50% stenosis, admitted to our hospital and conformed by DSA from September 2015 to February 2017, were collected in this study. Collateral circulation compensation was assessed by DSA. The distal stenosis pressure (Pd) and stenosis pressure (Pa) were measured by pressure wire system; the pressure ratio across stenosis was recorded. Correlations of pressure ratio with stenosis rate and collateral circulation compensation were analyzed by Spearman correlation. Results Thirty one stenotic extracranial cerebral arteries (9 of carotid stenosis, 12 of vertebral artery stenosis and 10 of subclavian artery stenosis) in 28 patients were collected. There were no perioperative complications or adverse events. The vascular stenosis rate showed negative correlation with pressure ratio (r=-0.615, P=-0.000). In the subgroups, pressure gradient was negatively correlated with carotid artery stenosis rate (r=-0.948, P=-0.000), vertebral artery stenosis rate (r=-0.757, P=0.004) and subclavian artery stenosis (r=-0.759, p=-0.011). Pressure ratio and collateral circulation compensation showed negative correlated relation (r=-0.475, P=0.007). Conclusion The pressure ratio across stenosis gets worse impairment with increase of severity of stenosis, and the collateral circulation influences the pressure ratio.
出处
《中华神经医学杂志》
CSCD
北大核心
2017年第11期1112-1116,共5页
Chinese Journal of Neuromedicine
关键词
颅外段脑动脉
血管狭窄
血管内压力
压力比
侧支循环
Extracranial cerebral artery
Vascular stenosis
Intravascular pressure
Pressureratio
Collateral circulation