两种不同分型胚胎型大脑后动脉对急性后循环脑梗死的影响研究

Effects of two different types of fetal-type posterior cerebral artery on acute posterior circulation infarction

目的:探讨两种分型胚胎型大脑后动脉(FTP)与急性后循环脑梗死疾病严重程度及预后的关系。方法:收集急性后循环脑梗死患者42例,所有患者均行颅脑数字减影血管造影(DSA)检查及续贯的血管内治疗。根据DSA结果将研究对象分为完全型胚胎型大脑后动脉(CFTP)组与部分型胚胎型大脑后动脉(PFTP)组。分析不同组别的胚胎型大脑后动脉与急性后循环脑梗死患者起病时临床症状的严重程度及术后预后的相关性。结果:共42例急性后循环脑梗死患者纳入研究,其中CFTP组18例,PFTP组24例(包含双侧PFTP1例)。单侧FTP所占比例为(1/42,2.38%),两组患者的术前NIHSS评分平均值存在统计学差异(P<0.05)。经血管内治疗后,两组NIHSS评分变化均值水平存在统计学差异(P<0.01)。通过术后90 d的随访,两组的MRS评分0~2分的分布上有统计学意义。结论:单侧胚胎型大脑后动脉更常见,其中合并完全型胚胎型大脑后动脉的急性后循环脑梗死患者相较于部分型胚胎型大脑后动脉患者的起病症状更轻,介入术后效果更好,远期生活质量更高。

Objective:To investigate the relationship of the severity and prognosis between two types fetal-type posterior cerebral artery(FTP)and acute posterior circulation infarction.Methods:Patients with acute posterior circulation circulation infarction were collected.All patients received DSA examination and consecutived interventional therapy.The subjects were divided into complete fetal posterior cerebral artery(CFTP)group and partial fetal posterior cerebral artery(PFTP)group according to the results of DSA.The correlation between fetal-type posterior cerebral artery in different groups and the severity of clinical symptoms and postoperative prognosis in patients was analyzed.Results:A total of 42 patients with acute posterior circulation infarction were included in the study,including 18 cases in the CFTP group and 24 cases in the PFTP group(including 1 case with bilateral PFTP).The proportion of unilateral FTP was 2.38%(1/42),and the average preoperative NIHSS score of the two groups was statistically different(P<0.05).After interventional therapy,there was a significant statistical difference in the mean level of NIHSS score between the two groups(P<0.01).After 90 days of follow-up,the distribution of MRS score of 0-2 in the two groups was statistically significant different.Conclusion:Unilateral fetal-type posterior cerebral artery is more common,and patients with acute posterior circulation infarction combined with complete fetal posterior cerebral artery have milder onset symptoms,better interventional effect and better long-term quality of life than patients with partial fetal posterior cerebral artery.