颅内侧枝循环开放程度与颈动脉支架置入术后短期预后的关系
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(新疆医科大学第一附属医院神经内科,新疆乌鲁木齐市 830054)

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阿力木·吾甫尔,博士研究生,主治医师,研究方向为脑血管病。

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The relationship between the intracranial collateral circulation and short-term prognosis after carotid artery stenting
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Department of Neurology, the First Affiliated Hospital, Xinjiang Medical University, Wulumuqi 830054, Xinjiang, China)

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    摘要:

    目的 探讨症状性颅外段颈动脉狭窄患者颅内血管侧枝循环开放程度对颈动脉支架置入术(CAS)后短期预后的影响。 方法 回顾性分析行CAS术的111例患者的脑血管造影资料,评估术前及术后脑血管侧枝循环的建立程度,以及对术后短期随访结果的影响。 结果 侧枝循环良好组为53例,侧枝循环差组为58例。侧枝循环良好组中,颈动脉严重狭窄、前交通动脉开放以及软脑膜动脉开放的比率明显高于侧枝循环差组,差异有统计学意义(P<0.05),而糖尿病患者的比例明显低于侧枝循环差组(P<0.05);CAS术后出现2例脑出血患者,均在侧枝循环良好组,所有患者随访1年,有3例患者再发脑梗死,均为侧枝循环差组病例。侧枝循环良好组术前及术后1年的NIHSS及mRS评分均明显低于侧枝循环差组。 结论 良好的侧枝循环可明显改善症状性颈动脉狭窄患者CAS术后的神经功能,可能是颈动脉支架置入术后发生脑梗死的保护因素。

    Abstract:

    Aim To investigate the influence of the intracranial collateral circulation on the short-term prognosis of symptomatic carotid artery stenosis after carotid artery stenting(CAS). Methods 111 patients with extracranial carotid artery stenosis were treated with stent in our hospital, the collateral circulation of patient and their rate of events at clinical end point during follow-up period were compared and analyzed. Results The patients in good collateral circulation group was 53, and in poor collateral circulation group was 58; Good collateralization was more frequently associated with serious ipsilateral ICA stenosis (≥90%), and was more obvious with the development of the anterior communicating artery (ACoA), leptomeningeal collaterals(LC)(P<0.05) and had negative correlation with diabetes (P=0.036); There were 2 patients with cerebral hemorrhage after CAS, and all of them were in good collateral circulation group; All patients were followed up for 1 year,and 3 cases of recurrent cerebral infarction were in poor collateral circulation group; The scores of NIHSS and mRS in good collateral circulation group were significantly lower than those of poor collateral circulation group before and after 1 year. Conclusion Good collateral circulation can improve the neurological function of symptomatic carotid stenosis patients, and may be a protective factor for ipsilateral stroke during clinical follow-up.

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阿力木·吾甫尔,韩登峰,哈力旦·加马力丁,夏提古力·亚力坤,周君,马建华.颅内侧枝循环开放程度与颈动脉支架置入术后短期预后的关系[J].中国动脉硬化杂志,2018,26(2):186~189, 193.

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  • 收稿日期:2017-06-08
  • 最后修改日期:2017-07-24
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  • 在线发布日期: 2018-03-07