侧支循环及其在缺血性脑卒中诊疗中的研究和应用现状

Collateral circulation in diagnosis and treatment of ischemic stroke and related application

急性缺血性脑卒中发病率高、致死率高、致残率高,给我国医疗卫生及国民健康造成了严重负担。时间窗或组织窗内进行血管开通是急性缺血性脑卒中治疗的首选,但仍有一部分患者在血管开通治疗后预后欠佳,其可能与患者侧支循环条件不良有关。侧支循环评估手段众多,其中数字剪影血管造影为金标准,CT血管造影是最常采用的手段。多项研究证实侧支循环条件与静脉溶栓、血管内治疗的预后有关,可以作为判断缺血性脑卒中预后的预测指标。随着影像技术的发展,侧支循环的重要性逐渐被认知,鉴于其与缺血性脑卒中等脑血管病的病理生理关系密切,可作为潜在的干预靶点辅助治疗,相关领域仍需进一步研究证实。

With high morbidity,mortality,and high disability rate,acute ischemic stroke brings a heavy burden on our public health.Artery recanalization is still the first line treatment strategy of ischemic stroke.However,quite a few patients who have received artery recanalization were still with poor outcome.Poor collateral circulation might be the cause.Various vascular examinations can be used to evaluate collateral circulation,among which DSA(digital substraction angiography)is the golden standard while CTA(computed tomography angiography)is the most common used.A few trials have found that collateral circulation is associated with the outcome of recanalization treatment,which can predict the prognosis of ischemic stroke.With advancement of radiology,the importance of collateral circulation is being recognized.With the close relation with the pathophysiology of ischemic stroke and its potential application in treatment,more trials in collateral circulation are needed.