【摘要】 目的:研究颈动脉狭窄或闭塞后侧支循环形成的方式以及和临床症状的相关性。方法:回顾性分析142例经DSA确定的颈动脉狭窄或闭塞后的侧支循环途径出现的概率、种类,并分析与影像学结果的相关性。结果:142例中78例(54.9%)出现侧支循环,其中Willis环代偿44例(56.4%),颅外代偿5例(6.4%),联合代偿29例(37.2%)。侧支循环的出现率与狭窄程度相关(P<0.05);双侧狭窄出现代偿的几率要高于单侧,联合代偿多见于单侧闭塞患者(P<0.05)。在单纯动脉狭窄时,Willis代偿是主要方式;合并颅内动脉狭窄时,联合代偿是其重要途径。分水岭梗死则多见于有侧支循环患者(P<0.05)。结论:不同狭窄程度影响侧支循环的形成,而后者与梗死类型有一定的相关性。更多还原

【Abstract】 Objective:To study the formation of collateral circulation after stenosis or occlusion of the carotid arteries.Methods:The clinical data of 142 patients with carotid stenosis or occlusion confirmed by DSA were studied.The collateral circulation and it’s association with brain imaging changes were analyzed retrospectively.Results:Seventy-eight patients(54.9%) formed collateral circulation,in which 44 cases were by Willis arterial circle(56.4%),5 by extracranial arteries(6.4%),and 29 by both the Willis arterial circle and extracranial arteries(37.2%).The formation of the collateral circulation was positively related to the degree of stenosis(P<0.05),in which the incurrence in patients with double stenosis was significantly higher than that with single stenosis(76.5% vs 52%).Joint compensation from both the cranial and extracranial arteries were more common in patients with unilateral occlusion(P<0.05).Compensation with Willis arterial circle was the main way in patients without cranial artery stenosis.However,joint compensation was the main style in patients with cranial artery stenosis.The formation of collateral circulation correlates with the types of cerebral infarction.Watershed infarction was preferentially observed in patients with collateral circulation.Conculsion: The degree of cerebral artery stenosis determines the formation of cerebral collateral circulation which was closely associated with the types of cerebral infarction.更多还原