刘 瑞



颅内外血管狭窄程度与颈内动脉系统短暂性脑缺血发作的相关性分析

刘 瑞

【摘要】目的 探讨颅内外血管狭窄程度与颈内动脉系统短暂性脑缺血发作次数与持续时间的关系。方法 对130 例颈内动脉TIA患者的全脑血管造影（DSA）进行分析，观察TIA患者的发作与颈内动脉颅内外段血管有无狭窄及狭窄程度的关系。结果 130例中有血管狭窄94 例（占72.3%）。颈内动脉颅外段狭窄 32例（占34.1%），颅内段狭窄16 例（占17.0%），大脑中动脉狭窄38 例（占40.4%），大脑前动脉狭窄8例（占8.5%）。其中频发TIA 44例，有血管狭窄35例，其中轻中度血管狭窄10例，重度狭窄血管25例。非频发组血管狭窄的有59例，其中轻中度血管狭窄38例，重度狭窄21例，两组患者比较说明TIA发生次数与血管狭窄程度有关。TIA发作持续时间＜10 min的58例患者中无血管狭窄15例，轻中度狭窄19例，重度狭窄24例；发作持续时间为10～59 min的65例患者中无血管狭窄17例，轻中度狭窄27例，重度狭窄21例；≥60 min的7例患者中无血管狭窄4例，轻中度狭窄3例，重度狭窄0例。数据表明症状持续时间与血管狭窄的程度无相关性。结论 颈内动脉TIA大多存在血管狭窄，TIA发作次数与血管狭窄程度有相关性，而发作持续时间与血管狭窄程度差异无统计学意义。

【关键词】短暂性脑缺血发作；血管狭窄程度；全脑血管造影

Objective To study intracranial vascular stenosis degree and internal carotid artery system transient ischemic attack frequency and duration of the relationship. Methods 130 cases of patients with internal carotid artery TIA cerebral angiography（DSA）were analyzed，and observation of patients with TIA attacks and the relationship between internal carotid artery stenosis and the degree of stenosi. Results In 130 patients with 94 cases of vascular stenosis （72.3%）. 32 cases of extracranial internal carotid artery stenosis （34.1%），16 cases of intracranial internal carotid artery stenosis （17.0%），38 cases of middle cerebral artery stenosis（40.4%），8 cases of cerebral artery stenosis before（8.5%）. Recurrent TIA of 44 cases，35 cases of vascular stenosis，including 10 patients with mild-to-moderate vascular stenosis，25 cases of severe stenosis vessels. Don't frequent set of vascular stenosis in 59 cases，38 patients with mild-to-moderate vascular stenosis，21 cases of severe stenosis，two groups of patients with vascular stenosis degree was statistically significant. Patients with TIA onset duration＜10 minutes of 58 cases，15 cases without vascular stenosis，19 patients with mildto-moderate stenosis，24 cases of severe stenosis. Onset duration of 10 to 59 minutes of 65 cases，17 cases without vascular stenosis，27 patients with mild-to-moderate narrow，21 cases of severe stenosis. Onset duration 60 minutes of 7 cases，4 cases of vascular stenosis，3 cases of mild-to-moderate narrow，0 cases of severe stenosis. TIA onset duration and vascular stenosis degree has no statistical significance. Conclusion There is a correlation between the frequency of TIA attack and the degree of vascular stenosis，and the duration of attack is not related to the degree of vascular stenosis in the carotid artery TIA.

【Key words】 Transient ischemic attack，Degree of vascular stenosis，Total cerebral angiography

短暂性脑缺血发作（TIA）是神经内科急症，可作为脑卒中的早期预警。有研究显示［1］TIA后90 d内再发卒中的机率为10% ～15%，但王拥军发表的一项9万多人的全国调查显示，国人对TIA的知晓率、规范诊治率、有效控制率均较低。……