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目的分析研究单侧颈内动脉狭窄或闭塞患者侧支循环情况,并探讨其与脑缺血之间的关系。方法 54例确诊为单侧颈内动脉狭窄或闭塞患者,根据颈内动脉狭窄程度和有无侧支代偿将患者分为颈内动脉闭塞组(A组)、有侧支代偿颈内动脉狭窄组(B组)和无侧支代偿颈内动脉狭窄组(C组),每组18例。比较三组患者的脑血流灌注(额叶、颞叶、顶叶、基底节、丘脑)现象。结果 A组患者的额叶、顶叶、颞叶、丘脑、基底节放射性计数比值分别为(0.82±0.18)、(0.84±0.16)、(0.86±0.14)、(0.78±0.13)、(0.87±0.12),B组分别为(1.02±0.14)、(0.94±0.13)、(1.16±0.24)、(0.97±0.16)、(0.91±0.16),C组分别为(0.87±0.16)、(0.76±0.15)、(0.91±0.17)、(0.94±0.14)、(0.92±0.15)。三组患者丘脑和基底节的血流灌注比较差异无统计学意义(P>0.05)。而三组患者额叶、顶叶、颞叶的血流灌注比较差异均具有统计学意义(P<0.05)。结论脑灌注损伤的出现与血管狭窄程度和侧支代偿有一定的关系,尽管二者不可直接对比,但可以使得脑缺血的相关认识进一步加强。
Objective To analyze the collateral circulation in patients with unilateral internal carotid artery stenosis or occlusion and to explore its relationship with cerebral ischemia. Methods Fifty-four patients with unilateral internal carotid artery stenosis or occlusion were divided into two groups according to the severity of carotid artery stenosis and the absence of collateral compensation (group A). The collateral compensated internal carotid artery The stenosis group (group B) and without collateral compensation internal carotid artery stenosis group (group C), 18 cases in each group. Cerebral perfusion (frontal lobe, temporal lobe, parietal lobe, basal ganglia, thalamus) was compared between the three groups. Results The radioactive counts of frontal lobe, parietal lobe, temporal lobe, thalamus and basal ganglia in group A were (0.82 ± 0.18), (0.84 ± 0.16), (0.86 ± 0.14), (0.78 ± 0.13) and (0.87 ± (0.97 ± 0.16), (0.91 ± 0.16), (0.87 ± 0.16) and (0.76 ± 0.16) in group B were significantly higher than those in group B (0.12 ± 0.14, 0.94 ± 0.13, 0.15), (0.91 ± 0.17), (0.94 ± 0.14), (0.92 ± 0.15). There was no significant difference in perfusion between thalamus and basal ganglia in three groups (P> 0.05). The three groups of patients with frontal lobe, parietal lobe, temporal lobe perfusion were significantly different (P <0.05). Conclusions The occurrence of cerebral perfusion injury has a certain relationship with the degree of stenosis and collateral compensation. Although the two can not be directly compared, it can make the related knowledge of cerebral ischemia further strengthened.