侧支循环对大脑中动脉重度狭窄患者梗死发病影响的分析

Analysis of the influence of collateral circulation on the incidence of cerebral infarction in patients with severe stenosis of middle cerebral artery

目的分析侧支循环对大脑中动脉重度狭窄患者梗死发病的影响。方法随机选取大脑中动脉重度狭窄患者88例。根据侧支情况分为侧支良好组和侧支减少组。本研究将对两组患者的发病类型,脑灌注参数和血液流变学进行测量对比,进行统计学分析。结果①侧支良好组42例,年龄(63.34±10.56)岁;高血压病32例(76.19%);收缩压(150.69±25.96)mmHg。侧支减少组46例,年龄(63.21±10.33)岁;高血压病22例(47.83%);收缩压(162.82±25.46)mmHg。两组相比,侧支良好组高血压比例明显增加,收缩压明显降低(P<0.05),其余因素差异均无统计学意义。②侧支良好组中无梗死灶患者比例最高(16例,38.09%),LTI比例最低(1例,2.38%);侧支减少组中PI比例最低(1例,2.17%),IBZI发生比例最高(15例,32.61%),P<0.05。③侧支良好患者患侧CBV明显增加,TTP、MTT明显延长。侧支减少组患侧TTP明显延长,MTT明显缩短,CBF明显增加(P<0.05)。④两组相比,侧支良好组Rcbv、Rcbf略高,Rmtt显著降低(P<0.05);两组的Rttp无明显差异(P>0.05)。⑤侧支良好组的血液流变学各项指标都低于侧支减少组(P<0.05)。结论良好的侧支循环可以降低大脑中动脉重度狭窄患者脑梗死的发生。

Objective To analyze the effect of collateral circulation on infarction in patients with severe stenosis of middle cerebral artery.Methods From September 2015 to September 2018,88 patients with severe stenosis of middle cerebral artery were randomly selected.According to the condition of lateral branch,they were divided into two groups:good side branch group and lateral branch reduction group.In this study,the incidence types,cerebral perfusion parameters and hemorheology of the two groups were measured and compared,and statistical analysis was carried out.Results①42 cases(63.34±10.56)years of age,32 cases(76.19%)of hypertension,and(150.69±25.96)cases of systolic blood pressure(SBP)in the group of good lateral branches,(63.34±10.56)years of age,32 cases of hypertension.There were 46 cases(63.21±10.33)years of age,hypertension 22 cases(47.83%),systolic blood pressure(162.82±25.46).Compared with the two groups,the ratio of hypertension in the good collateral group was significantly increased and the systolic blood pressure detail was significantly decreased(P<0.05),there were no significant differences in other factors between the two groups.②There were 88 patients in the two groups,the number of each type of disease was shown in Table 2.In the group of good collateral branches,the proportion of patients with non-infarction focus was the highest(16 cases,38.09%),LTI was the lowest(1 cases,2.38%),and the ratio of PI was the lowest in the group of lateral branch reduction(1 cases,2.17%).IBZI was the highest(15 cases,32.61%),P<0.05.③CBV and TTP,MTT were significantly increased and TTP,MTT prolonged in the patients with good collateral branches.The TTP of the affected side was prolonged,the MTT of the affected side was significantly shortened and the CBF of the affected side was significantly increased(P<0.05).④The Rcbv,Rcbf of the good lateral branch group was slightly higher and the Rmtt of the affected side was significantly lower than that of the control group(P<0.05).There was no significant difference in Rttp between the two groups(0.05).⑤The indexes of hemorheology in the well-measured group were lower than those in the decrease group(0.05).Conclusion Good collateral circulation can reduce the incidence of cerebral infarction in patients with severe stenosis of middle cerebral artery.