慢性单侧颈内动脉闭塞患者脑动脉血流动力学变化

中国综合临床 Pub Date : 2019-05-01 DOI:10.3760/CMA.J.ISSN.1008-6315.2019.03.002

Pingshu Zhang, Xiaoying Wu, Linlin Qian, S. Qiao, Yan Liu

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Qiao, Yan Liu","doi":"10.3760/CMA.J.ISSN.1008-6315.2019.03.002","DOIUrl":null,"url":null,"abstract":"Objective \nTo analyze the hemodynamic changes of cerebral arteries in patients with chronic extracranial internal carotid artery occlusion(EICAO). \n \n \nMethods \nNinety-six patients with chronic unilateral EICAO who were admitted to Kailuan General Hospital from September 2012 to December 2015 were selected as the case group (EICAO group), and 30 volunteers were selected as the control group.Color transcranial Doppler ultrasonography was used to detect the anterior communicating artery (ACOA) of the grade I collateral circulation, the posterior communicating artery (PCOA), the ocular artery of the grade II collateral circulation, and the pial collateral branch.Circulation rate and cerebral hemodynamic parameters: (Mean blood flow velocity (Vm) and pulsatility index). \n \n \nResults \nIn the left and right EICAO groups, the opening rates of collateral circulation at grade I were 86.96% (40/46), 96.00% (48/50) and 78.26% (36/46) and 88.00% (44/50) respectively.There were significant differences in the opening rates of collateral circulation at grade I between the two groups (χ2=4.114, P=0.043). There was no significant difference in the opening rates of collateral circulation at grade II between the two groups (χ2=3.544, P=0.060). The left and right sides of EICAO group were compared with the same side of control group.The Vm of the common carotid artery (left side of the EICAO group (24.08±9.25) cm/s), left side of the control group (32.52±3.28) cm/s, P<0.01); right side of the EICAO group (22.20±5.51) cm/s), right side of the control group(31.58±3.35) cm/s, P<0.01)) and the end-carotid artery end stage (TICA) The pulsation index (left side of left EICAO group (0.78±0.17), left side of control group (0.92±0.08), P<0.01); right side of right EICAO group(0.75±0.19), right side of control group (0.91±0.10), P<0.01), Vm of middle cerebral artery (MCA) (left side of left EICAO group(40.29 ±20.61) cm/s, left side of control group(55.72 ±5.60) cm/s, right side of EICAO; The right side of group (37.10±19.70) cm/s), the right side of control group (53.70±6.28) cm/s, P<0.01), the pulsation index of MCA (left side of left EICAO group(0.74±0.19), left side of control group(0.87±0.10), P<0.01; right side of right EICAO group(0.69±0.23), right side of control group: (0.90±0.08), P<0.01). There were significant differences.NIHSS score of neurological impairment: normal 17.39% (8/46), mild 39.13% (18/46), moderate 30.44% (14/46), moderate severe 13.04% (6/46) in left EICAO group, and normal 18.00% (9/50), mild 54.00% (27/50), moderate 24.00% (12/50), moderate severe 4.00% (2/50) in right EICAO group.There was no significant difference between the two groups (P=0.178). \n \n \nConclusion \nThe ipsilateral common carotid artery and its distal middle cerebral artery in patients with chronic unilateral internal carotid artery occlusionshow hypoperfusion of hemodynamics, accompanied by neurological impairment. \n \n \nKey words: \nInternal carotid artery occlusion; Collateral circulation; Hemodynamics; Nerve function","PeriodicalId":10365,"journal":{"name":"中国综合临床","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Hemodynamic changes of cerebral arteries in patients with chronic unilateral internal carotid artery occlusion\",\"authors\":\"Pingshu Zhang, Xiaoying Wu, Linlin Qian, S. 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There was no significant difference in the opening rates of collateral circulation at grade II between the two groups (χ2=3.544, P=0.060). The left and right sides of EICAO group were compared with the same side of control group.The Vm of the common carotid artery (left side of the EICAO group (24.08±9.25) cm/s), left side of the control group (32.52±3.28) cm/s, P<0.01); right side of the EICAO group (22.20±5.51) cm/s), right side of the control group(31.58±3.35) cm/s, P<0.01)) and the end-carotid artery end stage (TICA) The pulsation index (left side of left EICAO group (0.78±0.17), left side of control group (0.92±0.08), P<0.01); right side of right EICAO group(0.75±0.19), right side of control group (0.91±0.10), P<0.01), Vm of middle cerebral artery (MCA) (left side of left EICAO group(40.29 ±20.61) cm/s, left side of control group(55.72 ±5.60) cm/s, right side of EICAO; The right side of group (37.10±19.70) cm/s), the right side of control group (53.70±6.28) cm/s, P<0.01), the pulsation index of MCA (left side of left EICAO group(0.74±0.19), left side of control group(0.87±0.10), P<0.01; right side of right EICAO group(0.69±0.23), right side of control group: (0.90±0.08), P<0.01). There were significant differences.NIHSS score of neurological impairment: normal 17.39% (8/46), mild 39.13% (18/46), moderate 30.44% (14/46), moderate severe 13.04% (6/46) in left EICAO group, and normal 18.00% (9/50), mild 54.00% (27/50), moderate 24.00% (12/50), moderate severe 4.00% (2/50) in right EICAO group.There was no significant difference between the two groups (P=0.178). \\n \\n \\nConclusion \\nThe ipsilateral common carotid artery and its distal middle cerebral artery in patients with chronic unilateral internal carotid artery occlusionshow hypoperfusion of hemodynamics, accompanied by neurological impairment. \\n \\n \\nKey words: \\nInternal carotid artery occlusion; Collateral circulation; Hemodynamics; Nerve function\",\"PeriodicalId\":10365,\"journal\":{\"name\":\"中国综合临床\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2019-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"中国综合临床\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2019.03.002\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"中国综合临床","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2019.03.002","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}

引用次数: 0

摘要

目的分析慢性颅外颈内动脉闭塞（EICAO）患者脑动脉血流动力学变化。方法选择2012年9月至2015年12月入住开滦总医院的96例慢性单侧EICAO患者作为病例组（EICAO组），30名志愿者作为对照组。彩色经颅多普勒超声检测Ⅰ级侧支循环的前交通动脉（ACOA）、后交通动脉（PCOA）、Ⅱ级侧支循环眼动脉和软脑膜侧支。循环速率和脑血流动力学参数：（平均血流速度（Vm）和搏动指数）。结果左、右EICAO组Ⅰ级侧支循环开放率分别为86.96%（40/46）、96.00%（48/50）、78.26%（36/46）和88.00%（44/50）。两组Ⅰ级侧支循环开放率有显著性差异（χ2=4.114，P=0.043），Ⅱ级侧支循环打开率无显著性差别（χ2=3.544，P=0.060），EICAO组左右侧与对照组同侧比较。颈总动脉Vm（EICAO组左侧（24.08±9.25）cm/s），对照组左侧（32.52±3.28）cm/s，P<0.01）；EICAO组右侧（22.20±5.51）cm/s），对照组右侧（31.58±3.35）cm/s，P<0.01）和颈动脉终末期（TICA）搏动指数（左EICAO左（0.78±0.17），对照左（0.92±0.08），P<0.01）；右侧EICAO组右侧（0.75±0.19），对照组右侧（0.91±0.10），P<0.01），大脑中动脉（MCA）Vm（左侧（40.29±20.61）cm/s，对照组左侧（55.72±5.60）cm/s、右侧；组右侧（37.10±19.70）cm/s），对照组右侧（53.70±6.28）cm/s，P<0.01），MCA搏动指数（左EICAO组左侧（0.74±0.19），对照对照组左侧（0.87±0.10），P<0.01；右侧EICAO组右侧（0.69±0.23），对照组右侧：（0.90±0.08），P<0.01）。神经损伤的NIHSS评分：左侧EICAO组为正常17.39%（8/46）、轻度39.13%（18/46）、中度30.44%（14/46）、中重度13.04%（6/46），右侧EICAO组为正常18.00%（9/50）、轻度54.00%（27/50）、中度24.00%（12/50）、中度-重度4.00%（2/50）。结论慢性单侧颈内动脉闭塞患者同侧颈总动脉及其大脑中动脉远端血流动力学灌注不足，伴有神经功能损害。关键词：颈内动脉闭塞；抵押品流通；血液动力学；神经功能

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Hemodynamic changes of cerebral arteries in patients with chronic unilateral internal carotid artery occlusion

Objective To analyze the hemodynamic changes of cerebral arteries in patients with chronic extracranial internal carotid artery occlusion(EICAO). Methods Ninety-six patients with chronic unilateral EICAO who were admitted to Kailuan General Hospital from September 2012 to December 2015 were selected as the case group (EICAO group), and 30 volunteers were selected as the control group.Color transcranial Doppler ultrasonography was used to detect the anterior communicating artery (ACOA) of the grade I collateral circulation, the posterior communicating artery (PCOA), the ocular artery of the grade II collateral circulation, and the pial collateral branch.Circulation rate and cerebral hemodynamic parameters: (Mean blood flow velocity (Vm) and pulsatility index). Results In the left and right EICAO groups, the opening rates of collateral circulation at grade I were 86.96% (40/46), 96.00% (48/50) and 78.26% (36/46) and 88.00% (44/50) respectively.There were significant differences in the opening rates of collateral circulation at grade I between the two groups (χ2=4.114, P=0.043). There was no significant difference in the opening rates of collateral circulation at grade II between the two groups (χ2=3.544, P=0.060). The left and right sides of EICAO group were compared with the same side of control group.The Vm of the common carotid artery (left side of the EICAO group (24.08±9.25) cm/s), left side of the control group (32.52±3.28) cm/s, P<0.01); right side of the EICAO group (22.20±5.51) cm/s), right side of the control group(31.58±3.35) cm/s, P<0.01)) and the end-carotid artery end stage (TICA) The pulsation index (left side of left EICAO group (0.78±0.17), left side of control group (0.92±0.08), P<0.01); right side of right EICAO group(0.75±0.19), right side of control group (0.91±0.10), P<0.01), Vm of middle cerebral artery (MCA) (left side of left EICAO group(40.29 ±20.61) cm/s, left side of control group(55.72 ±5.60) cm/s, right side of EICAO; The right side of group (37.10±19.70) cm/s), the right side of control group (53.70±6.28) cm/s, P<0.01), the pulsation index of MCA (left side of left EICAO group(0.74±0.19), left side of control group(0.87±0.10), P<0.01; right side of right EICAO group(0.69±0.23), right side of control group: (0.90±0.08), P<0.01). There were significant differences.NIHSS score of neurological impairment: normal 17.39% (8/46), mild 39.13% (18/46), moderate 30.44% (14/46), moderate severe 13.04% (6/46) in left EICAO group, and normal 18.00% (9/50), mild 54.00% (27/50), moderate 24.00% (12/50), moderate severe 4.00% (2/50) in right EICAO group.There was no significant difference between the two groups (P=0.178). Conclusion The ipsilateral common carotid artery and its distal middle cerebral artery in patients with chronic unilateral internal carotid artery occlusionshow hypoperfusion of hemodynamics, accompanied by neurological impairment. Key words: Internal carotid artery occlusion; Collateral circulation; Hemodynamics; Nerve function

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来源期刊

中国综合临床

CiteScore

0.10

自引率

0.00%

发文量

16855

期刊介绍： Clinical Medicine of China is an academic journal organized by the Chinese Medical Association (CMA), which mainly publishes original research papers, reviews and commentaries in the field. Clinical Medicine of China is a source journal of Peking University (2000 and 2004 editions), a core journal of Chinese science and technology, an academic journal of RCCSE China Core (Extended Edition), and has been published in Chemical Abstracts of the United States (CA), Abstracts Journal of Russia (AJ), Chinese Core Journals (Selection) Database, Chinese Science and Technology Materials Directory, Wanfang Database, China Academic Journal Database, JST Japan Science and Technology Agency Database (Japanese) (2018) and other databases.