数字减影血管造影分析缺血性脑血管病的责任动脉

目的 分析缺血性脑血管病患者的责任供血动脉狭窄或闭塞的发生特点.方法 回顾性分析304例缺血性脑血管病患者的DSA资料,其中短暂性脑缺血发作(transient ischemic attack,TIA)188例,脑梗死116例,判断责任动脉,测量其狭窄段长度和狭窄程度.结果 在304例患者中,227例(74.7%)可见脑供血动脉狭窄或闭塞,193例(85.0%)可判断责任动脉,其中104例(53.9%)为单纯颅外动脉、70例(36.3%)为单纯颅内动脉、19例(9.8%)为颅内外动脉串联病变.脑梗死组脑供血动脉狭窄或闭塞发生率(97/116,82.9%)显著高于TIA组(130/188,68.8%)(P<0.01).TIA组后循环颅外血管病变发牛率(26/107,24.3%)显著高于脑梗死组(6/86,7.0%)(P<0.01),脑梗死组前循环颅内血管病变发生率(28/86,32.6%)显著高于TIA组(22/107,20.6%)(P<0.01),但IIA组责任动脉狭窄长度和程度与脑梗死组无显著差异.结论 脑梗死组脑供血动脉狭窄或闭塞较IIA组更多见,TIA组以后循环颅外血管病变多见,脑梗死组以前循环颅内血管病变多见,而脑缺血程度与责任动脉狭窄程度和长度无关.

Digital subtraction angiography analysis of guilty artery in ischemic cerebrovascular disease

Objeclive To analyze the occurrence characteristics of stenosis or occlu-sion in guilty artery in patients with ischemic cerebrovascular disease. Methods The data of digital subtraction angiography (DSA) of 304 patients with ischemic cerebrovascular disease were analyzed retrospectively, in which there were 188 patients with transient ischemic attack (TIA) and 116 patients with cerebral infarction. Guilty arteries were identified, and the length of stenotic segment and severity of stenosis were measured. Results Of the 304 patients, 227 (74. 7%) had cerebral artery stenosis or occlusion. 193 (85.0%) identified guilty arteries, in which 104 (53.9%) were in extracranial artery only, 70 (36. 3%) were in intracranial artery only, and 19 (9. 8%) were in both intra- and extracranial arteries, The incidence of cerebral artery stenosis or occlusion (97/116, 82.9%) in the cerebral infarction group was significantly higher than that in the TIA group (130/188, 68.8%) (P <0. 01); the incidence of extracranial vascular lesions in posterior circulation in the TIA group was significantly higher than that in the cerebral infarction group (24.3% vs. 7.0%, P < 0. 01); and the incidence of intracranial vascular lesions in anterior circulation in the cerebral infarction group was significantly higher than that in the TIA group (32.6% vs. 20.6%, P <0. 01). However, there yeas no significant difference bergen the TIA group and the cerebral infarction group in the length of stenosis and severity of guilty artery. Conclusions Cerebral artery stenosis or occlusion in the in the cerebral infarction group is more common than that in the TIA group. The extracranial artery lesions in posterior circulation is more common in the TIA group, and the intracranial artery lesions in anterior circulation is more common in the cerelral infarction group, while the severity of cerebral ischemia is not associated with the stenosis degree and length of guilty artery.