CTA对急性脑梗死侧支循环的评估价值及与术后近期预后的相关性分析

Value of CT Angiography(CTA)in the Evaluation of Collateral Circulation of Acute Cerebral Infarction and Its Correlation with Short-term Prognosis

目的旨在分析CT血管成像(CTA)对急性脑梗死侧支循环的评估价值及与术后近期预后的相关性。方法回顾分析本院在2017年8月到2019年8月收治的66例急性脑梗死患者的临床资料,所有患者均进行多层螺旋CT(MSCT)检查。根据MSCT检查结果评估患者是否出现侧支循环代偿,采用Logistic回归分析治疗15d后影响急性脑梗死侧支循环形成因素。结果通过MSCT检查情况得出存在侧支循环者有36例(54.54%),无侧支循环患者30例(45.45%)。单因素分析两组患者在年龄、性别、糖尿病、高血脂、冠心病、发病到溶栓时间、入院NIHSS评分比较差异无统计学意义(P>0.05);在高血压史、入院rLMC评分、脑动脉狭窄程度上比较差异有统计学意义(P<0.05)。两组患者在入院NIHSS评分上比较无差异(P>0.05),治疗后,有侧支循环组NIHSS评分明显高于无侧支循环组(P<0.05)。结论CTA可有效评估急性脑梗死侧支循环形成情况,有侧支循环代偿能者预后情况较佳,可为临床评估侧支循环提供参考。

Objective To analyze the value of CT angiography(CTA)in evaluating collateral circulation of acute cerebral infarction and its correlation with short-term prognosis.Methods The clinical data of 66 patients with acute cerebral infarction admitted to our hospital august 2017 to august 2019 were retrospectively analyzed.All patients underwent multi-slice spiral CT(MSCT)examination.According to the results of MSCT examination,the patients were estimated whether there was collateral circulation compensation.Logistic regression analysis was used to analyze the factors affecting the formation of collateral circulation in acute cerebral infarction after 15 days of treatment.results According to the MSCT examination,36 patients(54.54%)had collateral circulation,and 30 patients(45.45%)had no collateral circulation.Univariate analysis showed that the differences in age,gender,diabetes,hyperlipidemia,coronary heart disease,time from attack to thrombolysis,NIHSS score at the time of admission were not statistically significant(P>0.05).There was a statistically significant difference in the history of hypertension,rLMC score at admission,and the degree of cerebral artery stenosis(P<0.05).Logistic regression analysis showed that the history of hypertension and the rLMC score at admission were risk factors for collateral circulation in patients with acute cerebral infarction(P<0.05).There was no difference in the NIHSS scores at admission between the two groups(P>0.05).After treatment,the NIHSS scores in the collateral circulation group were significantly higher than those in the non-collateral circulation group(P<0.05).Conclusion CTA can effectively evaluate the formation of collateral circulation in acute cerebral infarction.The prognosis of patients with collateral circulation compensation is better,providing a reference for clinical evaluation of collateral circulation.