论文部分内容阅读
[目的]探讨单侧大脑中动脉(MCA)狭窄或闭塞患者侧支循环代偿与神经功能缺损的关系。[方法]对86例MCA供血区域梗塞患者,在1周内进行TCD检查,并在入院当天及d21进行美国国立卫生研究院卒中量表(NIHSS)评分。[结果]65例患者有大脑前动脉(ACA)代偿,32例患者有大脑后动脉(PCA)代偿,27例患者既有ACA又有PCA代偿。病例组RVACA明显较对照组高(P﹤0.01);MCA主干及皮层支梗死患者的RVACA明显较对照组及深穿支梗死组高(P﹤0.01,P﹤0.05)。既有ACA又有PCA代偿的患者发病时、21dNIHSS评分均显著低于ACA代偿患者与PCA代偿患者;而ACA代偿患者又显著低于PCA代偿患者(均P﹤0.01)。[结论]大脑中动脉狭窄程度越重,侧支开放出现的频率和级别越高;侧支循环状况好的患者病情相对轻,预后较好。
[Objective] To investigate the relationship between collateral circulation compensatory function and neurological deficits in patients with unilateral middle cerebral artery (MCA) stenosis or occlusion. [Methods] TCD was performed within one week in 86 patients with MCA infarction. The National Institutes of Health Stroke Scale (NIHSS) was scored on the day of admission and d21. [Results] 65 patients had anterior cerebral artery (ACA) compensation, 32 patients had posterior cerebral artery (PCA) compensation, 27 patients had both ACA and PCA compensation. The RVACA in case group was significantly higher than that in control group (P <0.01). The RVACA in MCA trunk and cortical branch infarction group was significantly higher than that in control group and deep penetrating infarction group (P <0.01, P <0.05). In patients with both ACA and PCA compensation, the 21-day NIHHS scores were significantly lower than those with ACA-compensated and PCA-compensated patients, while those with ACA-compensated patients were significantly lower than those with PCA-compensated (all P <0.01). [Conclusion] The more severe the middle cerebral artery stenosis, the higher the frequency and level of collateral openness appears. The patients with collateral circulation are relatively light and the prognosis is good.