【摘要】 目的 分析多时相CT血管成像（computer tomography angiography, CTA）测定急性缺血性脑卒中患者侧支循环状况对患者静脉溶栓后的预后效果影响。方法 回顾性选取2021年1月—2022年8月南京市六合区人民医院收治的急性缺血性脑卒中溶栓治疗患者84例为研究对象，按照多时相CTA检查结果将其分为侧支良好组48例和侧支不良组36例。对比两组溶栓后24 h美国国立卫生院神经功能缺损评分（NIHSS评分）、30 d病死率、90 dmRS评分以及症状性脑出血发生率。结果 溶栓后24 h两组NIHSS评分均低于入院时，且侧支良好组低于侧支不良组，差异有统计学意义（P<0.05）。侧支良好组90 d预后良好率高于侧支不良组，症状性脑出血发生率低于侧支不良组，差异有统计学意义（P<0.05）。侧支良好组ASPECTS评分高于侧支不良组，90 d mRS评分低于侧支不良组，差异有统计学意义（P<0.05）。采用Spearman分析，ASPECTS与MRS呈负相关性（r=-0.671,P<0.05）。结论 通过多时相CTA测定急性缺血性脑卒中患者侧支循环状况，可为患者静脉溶栓效果提供一定指导意义。更多还原

【Abstract】 Objective Multi-temporal CT angiography(CTA) was used to determine the influence of collateral circulation on the prognosis of patients with acute ischemic stroke after intravenous thrombolysis. Methods A total of 84 patients with acute ischemic stroke treated with thrombolysis in Liuhe District People’s Hospital of Nanjing from January 2021 to August 2022 were retrospectively selected as the study objects.According to the results of multi-temporal CTA examination, they were divided into 48 patients with good collateral and 36 patients with bad collateral. National Institutes of Health Neurological deficit Score(NIHSS score) at 24 h after thrombolysis, mortality at 30 d, 90 dmRS score and incidence of symptomatic cerebral hemorrhage were compared between the two groups. Results 24 h after thrombolysis, the NIHSS score of both groups was lower than that of admission, and the good collateral was lower than that of bad collateral, and the difference was statistically significant(P<0.05). The good prognosis rate at 90 days in good collateral group was higher than that in bad collateral group, and the incidence of symptomatic cerebral hemorrhage was lower than that in bad collateral group, and the difference was statistically significant(P<0.05). The ASPECTS score of good collateral group was higher than that of poor collateral group, and the mRS Score at 90 days was lower than that of poor collateral group, and the difference was statistically significant(P<0.05). Spearman analysis showed that ASPECTS were negatively correlated with MRS(r=-0.671, P<0.05). Conclusion The determination of collateral circulation in patients with acute ischemic stroke by multi-temporal CTA can provide some guidance for the efficacy of intravenous thrombolysis.更多还原