全脑血管造影对动脉粥样硬化性短暂性脑缺血发作风险评估的作用(1)
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[摘要] 目的：借助全脑血管造影(DSA)和ABCD2工具观察短暂性脑缺血发作(TIA)临床表现与血管病变之间的关系，探讨TIA发生卒中风险的原因。方法：128例TIA患者入院时根据ABCD2评分分组，高风险组58例，中低风险组70例，观察血管狭窄的程度和分布，血流代偿，溃疡斑块存在的情况。结果：高风险组狭窄≥70%的发生率为67.2%，高于中低风险组(51.4%)(χ2=6.242，P<0.05)；高风险组溃疡斑块的发生率为51.7%，高于中低风险组(38.6%)(χ2=6.027，P<0.05)，中低风险组血流代偿的发生率为77.1%，高于高风险组(65.5%)(χ2=5.913，P<0.05)。结论：TIA高风险的可能原因为血管狭窄造成的低灌注和溃疡斑块微栓子脱落导致的栓塞，有血流代偿可能起了到缓解病情的作用。
[关键词] 全脑血管造影；动脉粥样硬化；短暂性脑缺血发作；病因
[中图分类号] R743.31 [文献标识码] B [文章编号] 1673-7210(2011)11(b)-091-02
Evaluative value of digital subtraction angiography in patients with arteriosclerosis and transient ischemic attacks
LI Guanglei, WANG Xiuyan
Department of Neurology, the Second Qinhuangdao City Hospital of Changli County, Hebei Province, Changli 066600, China
[Abstract] Objective: To observe the relationship between the clinical manifestation and cerebral artery disease by brain digital subtraction angiography (DSA) and ABCD2 score, and investigate the risk factor of cerebral infarction induced by transient ischemic attacks. Methods: 128 patients with TIA were divided into two groups: a higher subsequent stroke risk group, a middle and lower subsequent stroke risk group by ABCD2 score. The cerebral artery stenosis, collateral circulation on the occurrence, unstable plaque were studied. Results: There were significant differences between the two groups, in incidence rate of ≥70% stricture (67.2% vs 51.4%, χ2=6.242, P<0.05), collateral circulation on the occurrence (65.5% vs 77.1%, χ2=5.913, P<0.05), unstable plaque (51.7% vs 38.6%, χ2=6.027, P<0.05). Conclusion: The cerebral artery stenosis and unstable plaque correlated with TIA are high risk factors; collateral circulation on the occurrence can effectively alleviate the clinical symptoms.
[Key words] Digital subtraction angiography; Arteriosclerosis; Transient ischemic attacks; Etiology
短暂性脑缺血发作(TIA)是脑梗死的先兆表现，由动脉粥样硬化导致的血管狭窄是TIA发病的常见原因，随着神经影像学的发展，脑血管形态引起学者们的重视，对TIA的发病机制及血管内治疗也有了进一步的认识，因此准确全面掌握患者脑血管的情况，成为防止TIA发展为脑梗死的关键。ABCD2系统是一个简单的临床工具，近年来用于TIA患者的危险分层。数字减影全脑血管造影(DSA)作为观察脑血管病变的金标准已在临床广泛应用 ......
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