分析侧支循环对脑梗死发病机制分型及NIHSS评分的影响

To analyze the influence of collateral circulation on the pathogenesis classification and NIHSS score of cerebral infarction

目的:探讨侧支循环对脑梗死发病机制分型及美国国立卫生院卒中量表(NIHSS)评分的影响。方法:选取2018年4月-2020年4月行CT血管造影(CTA)检查的脑梗死患者115例,了解侧支循环开放情况,并比较侧支循环开放与未开放患者的临床资料、病理机制分型及治疗前后NIHSS评分。结果:115例患者中,CTA检查显示侧支循环开放40例,未开放75例;侧支循环开放与未开放患者的一般资料比较,差异无统计学意义(P>0.05);侧支循环开放组动脉-动脉栓塞、载体动脉阻塞穿支动脉所占比例高于未开放组,低灌注/栓子清除下降所占比例低于未开放组,差异有统计学意义(P<0.05);侧支循环开放组治疗前及治疗后NIHSS评分均低于未开放组,差异有统计学意义(P<0.05);侧支循环开放组与未开放组治疗后NIHSS评分均低于治疗前,差异有统计学意义(P<0.05)。结论:侧支循环可影响脑梗死发病机制分型及NIHSS评分,需引起高度关注。

Objective:To analyze the influence of collateral circulation on the pathogenesis classification and NIHSS score of cerebral infarction.Methods:From April 2018 to April 2020,115 patients with cerebral infarction underwent CT angiography(CTA)examination were selected.We understood the opening of collateral circulation,and compared the clinical data,pathological mechanism classification and NIHSS score before and after treatment of patients with and without opening of collateral circulation.Results:In 115 patients,CTA showed that collateral circulation was open in 40 cases and not open in 75 cases.There was no significant difference in general information between patients with and without collateral circulation(P>0.05).In the open collateral circulation group,the proportion of artery-artery embolism,carrier artery occlusion perforating artery was higher than that in the unopened group,and the proportion of hypoperfusion/decreased embolus clearance was lower than that in the unopened group,the difference was statistically significant(P<0.05).In the open collateral circulation group,the NIHSS scores before and after treatment were lower than those in the unopened group,the difference was statistically significant(P<0.05).In the open collateral circulation group and unopened group,the NIHSS score after treatment was lower than that before treatment,the difference was statistically significant(P<0.05).Conclusion:Collateral circulation can affect the classification of cerebral infarction pathogenesis and NIHSS score,which should be paid close attention to.