| 摘要: |
| ［摘要］ 目的 探讨脑侧支循环对急性脑梗死患者静脉溶栓疗效及预后的影响。方法 选择2018年1月至2019年12月在柳州市人民医院接受静脉溶栓治疗并行脑血管数字减影血管造影(DSA)检查的121例急性脑梗死患者的病历资料。根据DSA结果将其分为侧支循环代偿良好组（3～4级，53例）和侧支循环代偿不良组（0～2级，68例）。比较两组溶栓后的脑梗死体积、美国国立卫生院卒中量表（NIHSS）评分、日常生活活动能力（ADL）评分及脑出血发生率等情况。结果 侧支代偿良好组溶栓后发生出血并发症4例（7.55%），侧支代偿不良组发生出血并发症15例（22.06%），两组比较差异有统计学意义（χ2=4.739，P=0.029）。侧支代偿良好组溶栓后脑梗死体积显著小于侧支代偿不良组［10.00(8.00，12.80)cm3 vs 37.00(28.25，44.25)cm3，P<0.05］。两组溶栓后NIHSS评分均呈下降趋势，ADL评分均呈上升趋势，且侧支代偿良好组的变化幅度均显著大于侧支代偿不良组（P<0.05）。结论 脑侧支循环对急性脑梗死患者的静脉溶栓疗效及预后有重要影响，良好的脑侧支循环可显著改善患者的预后。 |
| 关键词: 急性脑梗死 侧支循环 静脉溶栓 数字减影血管造影 |
| DOI：10.3969/j.issn.1674-3806.2021.09.09 |
| 分类号:R 743.4 |
| 基金项目:广西卫健委科研课题（编号：Z20180284） |
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| Effect of cerebral collateral circulation on the efficacy and prognosis of intravenous thrombolysis in patients with acute cerebral infarction |
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HUANG Guang-jian, GAO Wen, QIN Hui-xun, et al.
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Department of Neurology, Liuzhou People′s Hospital, Guangxi 545006, China
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| Abstract: |
| ［Abstract］ Objective To explore the effect of cerebral collateral circulation on the efficacy and prognosis of intravenous thrombolysis in patients with acute cerebral infarction. Methods The medical records of 121 patients with acute cerebral infarction who received intravenous thrombolytic therapy and cerebral vascular digital subtraction angiography(DSA) examination in Liuzhou People′s Hospital from January 2018 to December 2019 were selected. According to the results of DSA, the patients were divided into good collateral circulation compensation group(grade 3～4, 53 cases) and poor collateral circulation compensation group(grade 0～2, 68 cases). The cerebral infarction volume, National Institute of Health Stroke Scale(NIHSS) score, Activities of Daily Living(ADL) score and the incidence of cerebral hemorrhage were compared between the two groups after thrombolysis. Results There were 4 cases(7.55%) of bleeding complications in the good collateral circulation compensation group after thrombolysis, and 15 cases(22.06%) of bleeding complications in the poor collateral circulation compensation group, and the difference between the two groups was statistically significant(χ2=4.739, P=0.029). The cerebral infarction volume in the good collateral circulation compensation group was significantly smaller than that in the poor collateral circulation compensation group after thrombolysis［10.00(8.00,12.80)cm3 vs 37.00(28.25,44.25)cm3, P<0.05］. After thrombolysis, the NIHSS scores showed a downward trend and the ADL scores showed an upward trend in the two groups, and the changing ranges of the good collateral circulation compensation group were significantly greater than those of the poor collateral circulation compensation group(P<0.05). Conclusion Cerebral collateral circulation has an important impact on the efficacy and prognosis of intravenous thrombolysis in patients with acute cerebral infarction. Good cerebral collateral circulation can significantly improve the prognosis of the patients. |
| Key words: Acute cerebral infarction Collateral circulation Intravenous thrombolysis Digital subtraction angiography(DSA) |
