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目的应用数字减影血管造影(DSA)探讨缺血性脑血管病(ICVD)患者脑血管病变的特点。方法对84例ICVD患者[其中脑梗死(CI)50例、椎-基底动脉供血不足(VBI)21例、短暂性脑缺血发作(TIA)13例]进行DSA检查,对颅内外病变血管的分布、血管狭窄程度及侧支循环代偿情况进行分析。结果本组84例ICVD患者中,血管狭窄的检出率为82.1%(69例);检出颅内外病变血管166条,以前循环(59.6%)以及颅内动脉(66.9%)受累为主,单条血管病变的发生率以颈内动脉颅外段最高(21.7%);狭窄程度1～4级的血管分别占27.1%、40.4%、6.6%及25.9%;58.0%的CI患者、33.3%的VBI患者和23.1%的TIA患者出现Willis环侧支循环代偿。结论DSA可准确评价ICVD患者颅内外病变血管的分布、狭窄程度以及侧支循环代偿情况,为临床治疗提供依据。
Objective To evaluate the characteristics of cerebrovascular diseases in patients with ischemic cerebrovascular disease (ICVD) by digital subtraction angiography (DSA). Methods DSA was performed in 84 patients with ICVD [including 50 cases of cerebral infarction (CI), 21 cases of vertebro-basilar insufficiency (VBI) and 13 cases of transient ischemic attack (TIA)], Distribution, degree of stenosis and collateral circulation compensation situation analysis. Results The detection rate of vascular stenosis was 82.1% (84 cases) in 84 ICVD patients in this group. 166 intracranial and extracranial vascular diseases were detected, the previous circulation (59.6%) and intracranial arteries (66.9%) were mainly affected, The incidence of single vessel disease was the highest in the extracranial segment of the internal carotid artery (21.7%). The vessels with stenosis grade 1 to 4 accounted for 27.1%, 40.4%, 6.6% and 25.9% respectively. In 58.0% CI patients, 33.3% Willis ring collateral circulation is compensated in VBI patients and in 23.1% of TIA patients. Conclusion DSA can accurately evaluate intracranial and extracranial vascular distribution, stenosis and collateral circulation compensatory status in ICVD patients, and provide a basis for clinical treatment.