摘要
目的通过磁共振血管成像（MRA）技术研究症状性单侧大脑中动脉（MCA）M1段闭塞患者不同途径的软脑膜动脉吻合代偿程度与神经功能缺损及预后的关系。方法选取2013年9月-2015年9月在我院住院经头颅MRI检查确诊MCA供血区脑梗死的症状性单侧MCA M1段闭塞患者140例,在发病1周内行MRA检查,根据软脑膜支代偿情况,分为4组,即无代偿组（21例）,单纯大脑前动脉（ACA）代偿组（43例）,单纯大脑后动脉（PCA）代偿组（28例）,ACA、PCA共同代偿组（48例）。在发病第1天及21天对神经功能缺损进行NIHSS评分。结果既有PCA又有ACA代偿组患者发病时及第21天NIHSS评分（6.52±3.56;5.41±2.64）均显著低于单纯PCA代偿组（11.58±6.62;10.20±5.32）与ACA代偿组（9.45±4.69;7.86±5.42）（均P〈0.01）;ACA代偿组显著低于PCA代偿组（P〈0.01）;有代偿组显著低于无代偿组（12.34±3.25;10.10±2.23）（P〈0.01）。结论 MCA皮质软脑膜侧枝吻合血管开放是MCA供血区脑梗死侧枝循环的主要途径,侧枝循环状况好的患者病情相对较轻,预后较好,前循环代偿较后循环代偿、有侧枝循环较无侧枝循环代偿患者病情相对较轻,预后较好。
Objective To explore the relationship of different ways of pial artery anastomosis between defect and prognosis of nerve function and the degree of compensation among patients with symptomatic unilateral middle cerebral artery（ MCA） occlusion of the M1 segment by magnetic resonance angiography（ MRA）. Methods 140 cases of patients who were confirmed the diagnosis of cerebral artery territory cerebral infarction symptoms of unilateral middle cerebral artery M1 segment occlusion were selected by cranial magnetic resonance examination from September 2013 to 2015 September in our hospital,in one week of the onset of expert MRA,according to the support on behalf of the pia mater compensation cases,divided into non compensatory group（ 21 cases）,simple anterior cerebral artery（ ACA） compensatory group 43 cases,simple posterior cerebral artery（ PCA） compensatory group（ 28 cases）,anterior cerebral and posterior cerebral artery compensatory group 48 cases. National Institutes of Health Stroke Scale（ NIHSS） score at the first day and 21 days. Results PCA compensatory than ACA compensation case multiple,both PCA and ACA compensatory group patients and 21 days NIHSS score were significantly lower than those of pure PCA and ACA compensatory group（ P〈0. 01）; ACA compensatory group was significantly lower than that of PCA compensatory group（ P〈0. 01）; Compensatory group was significantly lower than that in non compensatory group（ P〈0. 01）. Conclusion MCA cortical leptomeningeal collateral anastomosis patency is the main way to the brain artery territory cerebral infarction and collateral circulation,with good collateral circulation in patients with relatively mild condition,the prognosis is good,before the circulatory compensatory later compensatory circulation,collateral circulation is no collateral circulation compensatory patients relatively light,the prognosis is good.
出处
《潍坊医学院学报》
2016年第2期84-86,共3页
Acta Academiae Medicinae Weifang
关键词
侧支循环
大脑中动脉
磁共振血管成像
软脑膜动脉
Collateral circulation
Middle cerebral artery
Magnetic resonance angiography
Leptomeningeal anastomosis
作者简介
徐萍萍（1988年～），女，在读硕士研究生。主要研究方向：脑血管病。
[通讯作者]刘志辉，E-mail：lzhh1957@126．com
