单侧颈内动脉闭塞患者的颅内侧支循环代偿与脑缺血发生的相关性(1)
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[摘要] 目的 探讨单侧颈内动脉颅外段闭塞患者颅内侧支循环代偿与脑缺血发生的关系。 方法 对82例颈动脉彩超发现单侧颈内动脉颅外段闭塞患者，根据临床有无前循环脑缺血症状和神经功能障碍定位体征分为无症状组(38例)和有症状组(44例)。采用经颅多普勒(TCD)检测82例患者侧支循环开放情况及大脑中动脉的平均血流速度。 结果 无症状组均出现侧支循环开放(100%)，无症状组侧支循环开放率高于有症状组(80%)，以2个或3个侧支联合开放为主。无症状组的前交通动脉(ACOA)开放率明显高于有症状组(P < 0.05)；无症状组中ACOA开放率明显高于后交通动脉(PCOA)，眼动脉(OA)侧支开放(P < 0.05)。无症状组患者大脑中动脉平均血流速度明显高于有症状组。 结论 单侧颈内动脉闭塞患者颅内侧支循环代偿与脑缺血的发生密切相关，联合代偿对颈内动脉闭塞患者颅内供血的代偿与临床预后至关重要，ACOA的开放是颈内动脉闭塞患者最主要的代偿途径。
[关键词] 单侧颈内动脉闭塞；侧支循环；TCD；脑缺血
[中图分类号] R543.4 [文献标识码] B [文章编号] 1673-9701(2012)30-0051-03
The relationship between the collateral circulation and ischemic brain lesion in patients with unilateral internal carotidartery occlusion
CHEN Huiling1 HE Yan1 ZENG Xuan2
1.Department of Neurology，Huizhou Municipal Central Hospital， Huizhou 516001， China； 2.Department of Ophthalmology， Huizhou Municipal Central Hospital， Huizhou 516001， China
[Abstract] Objective To approach the collateral circulation and ischemic brain lesion in patients with unilateral internal carotidartery occlusion. Methods All of 82 patients with unilateral internal carotidartery occlusion those were found by ultrasonography were divided into two groups (unilateral internal carotidartery occlusion with symptomatic and unilateral internal carotidartery occlusion without symptomatic). Collateral circulation pathway in circle of Willis and the mean flow velocity of the middle cerebralartries were measured by TCD. Results The patients with collateral circulation in asymptomatic group was 100% (most of them with two or three collateral circulations)，which was higher than that in symptomatic group (P < 0 ......
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