首都医科大学学报 ›› 2008, Vol. 29 ›› Issue (1): 38-41.

• 专题报道 • 上一篇    下一篇

单侧大脑中动脉狭窄或闭塞侧支循环与脑缺血的关系

何洁, 吉训明, 张人玲, 翟勇, 关乐, 许英路   

  1. 1. 首都医科大学宣武医院核医学科;2. 首都医科大学宣武医院神经外科
  • 收稿日期:2007-11-18 修回日期:1900-01-01 出版日期:2008-02-24 发布日期:2013-07-15

Study on the Relation between Collateral Circulation and Cerebral Ischemia in Patients with Unilateral Middle Cerebral Artery Stenosis or Occlusion

He Jie, Ji Xunming, Zhang Renling, Zhai Yong, Guan Yue, Xu Yinglu   

  1. 1. Department of Nuclear Medicine, Xuanwu Hospital, Capital Medical University;2. Department of Neurosurgery, Xuanwu Hospital, Capital Medical University
  • Received:2007-11-18 Revised:1900-01-01 Online:2008-02-24 Published:2013-07-15

摘要: 目的 探讨单侧大脑中动脉(MCA)狭窄或闭塞患者侧支循环代偿与脑缺血的关系.方法 将27例单侧大脑中动脉狭窄或闭塞患者根据有无侧支代偿分为2组,分别对2组患者的脑血流灌注显像结果进行对比分析.结果 17例单侧大脑中动脉狭窄患者中4例有侧支代偿,13例无侧支代偿.10例单侧大脑中动脉闭塞患者中7例有侧支代偿,3例无侧支代偿.当大脑中动脉受阻时,侧支代偿多见于血管闭塞患者,而无侧支代偿多见于动脉狭窄患者(χ2=5.632,P=0.018).2组患者额、颞、顶、枕叶及基底节的血流灌注差异无统计学意义,但2组患者丘脑的血流灌注差异有统计学意义(t=-2.393,P=0.025).结论 当单侧大脑中动脉狭窄或闭塞时,由于侧支循环的存在,脑灌注损伤与血管狭窄程度表现不一致,联合应用2种脑血管造影和脑血流灌注方法可对MCA受阻有全面认识.

关键词: 大脑中动脉狭窄或闭塞, 体层摄影术, 发射型计算机, 侧支循环

Abstract: Objective To study the relation between collateral circulation and ischemic brain lesions in patients with unilateral middle cerebral artery stenosis or occlusion.Methods Twenty-seven patients with unilateral middle cerebral artery stenosis or occlusion were divided into two groups according the status of collateral circulation.Comparisons were made between the results of the two groups in cerebral blood flow perfusion imaging.Results In 4 patients with unilateral middle cerebral artery stenosis and 7 patients with unilateral middle cerebral artery occlusion,collateral circulation appeared,and in 13 patients with unilateral middle cerebral artery stenosis and 3 patients with unilateral middle cerebral artery occlusion,collateral flow could not be seen.Collateral flow appeared more frequently in the patients with unilateral middle cerebral artery occlusion than in those with unilateral middle cerebral artery stenosis(χ2=5.632,P=0.018).In the frontal,temporal,parietal,occipital cortices and basal ganglia,the cerebral blood flow volumes were not significantly different between the two groups.In the thalamus however,they showed significant difference(t=-2.393,P=0.025).Conclusion Ischemic brain lesions in patients with unilateral middle cerebral artery stenosis or occlusion does not in accord with the degree of vascular stenosis.It would improve the understanding of the severity of middle cerebral artery stenosis or occlusion considerably by combining angiographic information and perfusion data.

Key words: middle cerebral artery stenosis or occlusion, tomography, emission-computed, collateral circulation

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