短暂性脑缺血发作患者脑动脉狭窄特点的分析-外科学专业论文.docxVIP

摘 要 短暂性脑缺血发作患者脑动脉狭窄特点的研究 研究生：杨旭森 导师：鲍遇海 教授 摘 要 目的：观察98例短暂性脑缺血发作患者全脑血管造影(DSA)影像学结果，分析 脑动脉狭窄的分布特点，评估脑动脉狭窄与缺血性脑血管病之间的关系。资料和方 法：1.回顾性研究98例临床诊断为短暂性脑缺血发作患者DSA结果。2.分析患者的 DSA结果归纳动脉狭窄或闭塞的部位和程度参照NASCET法将狭窄程度分为以下5 级: ①正常，②轻度狭窄29%，③中度狭窄( 30% ～69% )，④重度狭窄，血管狭窄 率( 70% ～99% )，⑤闭塞(100%)。3.根据狭窄部位与颅脑的关系分为颅内段狭窄和 颅外段狭窄;按发病时的临床表现,分为颈动脉系统TIA组(65例)与椎-基底动脉系统 TIA组(33例)。结果：1.本研究共87例患者存在颅内-外动脉狭窄 。颅外动脉狭窄以 颈内动脉颅外段最多,占14.4% (21 /146) ,而颅内动脉狭窄则以大脑中动脉最多,占 29.5% (43 /146) 。颅内、颅外狭窄动脉比约为2∶1(98 /48) 。2. CA-TIA组中单纯颅 外病变和颅内外联合高于单纯颅内病变，而VB-TIA组中颅内外联合病变高于单纯颅 外病变和单纯颅内病变。 CA-TIA组单纯前循环病变的发生率高于 VB-TIA组， VB-TIA组单纯后循环的发生率高于CA-TIA组。3.最常见的侧枝循环是Wlliis环和软 膜血管，严重的脑供血动脉狭窄更易引发侧枝循环。结论：颅内外动脉狭窄是短暂 性脑缺血发作重要发病基础;且颅内段血管狭窄较颅外段血管狭窄多见，CA-TIA组 单纯前循环病变的发生率高于 VB-TIA组， VB-TIA组单纯后循环的发生率高于 CA-TIA组。最常见的侧枝循环是Wlliis环和软膜血管，严重的脑供血动脉狭窄更易 引发侧枝循环。 关键词: 短暂性脑缺血发作；脑动脉狭窄；侧枝循环；数字减影血管造影 新疆医科大学医学硕士学位论文 A Clinical Study on the Characteristics ofCerebral Artery Stenosis in Patients with Transient Ischemic Attack Postgraduate: Yang xusen Advisor: Prof. Bao yuhai Abstact Objectives:To analyze the characteristics of the distribution of transient ischemic attack，evaluate the relationship of cerebral artery stenosis with results of coornal DSA of 98 patients with transient ischemic attacks.Subjects and methods:1. The clinical data from98 patients with transient ischemic attack （ TIA ） who had cerebral angiography were analyzed retrospectively.2.Analyzing the results of DSA of aortic arch and the whole brain and summarizing the degree and localization of artery stenosis and obstruction. According to NASCTE grouping，the degree of artery stenosis were divided into 5 levels: ①normal，in which no artery stenosis,②lightrange，which was obstructed not more than 29%,③midrange，which was obstructed more than 30% and not more than 69%.④seriousrange，which obstructed more than 70%.⑤obstruction thorouhgly. 3 .All the patients were divided into carotid artery system TIA (CA-TIA, n = 65) and vertebro-basilar artery system TIA (VB-TIA, n = 33) groups according to