摘要
目的探讨自发性头颈部动脉夹层（sCAD）临床特点及药物疗效。方法对2005—2008年10例经DSA确诊的sCAD患者的危险因素、临床表现、DSA特征及药物疗效进行分析。结果10例sCAD患者中，3例有高血压病史，3例病前上呼吸道感染史，2例合并肌纤维发育不良。临床特点：除1例表现为偏头痛外，其余均表现为缺血性脑血管病。DSA检查发现3例表现为颈内动脉长段鼠尾状狭窄，3例可见到内膜瓣，2例为夹层动脉瘤。5例患者进行肝素抗凝治疗，之后2例予华法林治疗，3例予抗血小板治疗；3例单用阿司匹林进行抗血小板治疗，都取得良好临床疗效。结论sCAD的诊断依靠患者的临床表现及特征性DSA表现，抗凝及抗血小板治疗均取得较好的临床治疗效果。
Objective To describe clinical features and evaluate drug therapy in cases with spontaneous cervicocerebral arterial dissection （sCAD）. Methods Ten cases of sCAD who visited Qingdao University Medical College during 2005-2008 were retrospectively reviewed and the risk factors, clinic manifestations, characteristic signs in imagine and outcome of drug therapy were summarized and analyzed. Results In 10 cases, risk factors related to sCAD included hypertension in 3 cases, recent respiratory tract infection in 3 cases, fibromuscular dysplasia in 2 cases. Clinic manifestations in 9 cases presented as ischemic cerebral diseases and in one case as migraine. DSA examination on the affected arteries revealed ＂string sign＂ of a long segment of narrowed lumen in 3 cases, intimal flap in 3 cases and dissecting aneurysm in 2 cases. Anticoagulation with heparin was used to treat sCAD in 5 cases, followed by warfarin in 2 cases and antiplatelet with aspirin in 3 cases. Aspirin only was used in 3 cases. The above eight cases receiving antithrombotic treatment （antiplatelet or anticoagulation） all reached good recovery. Two cases with dissecting aneurysm were not given antithrombotic treatment. Conclusions Diagnosis of sCAD may depend on clinical manifestations and characteristic signs on DSA examination. Anticoagulation or antiplatelet therapies are effective treatment in sCAD.
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2009年第9期611-614,共4页
Chinese Journal of Neurology
关键词
颈动脉狭窄
动脉瘤
夹层
血管造影术
数字减影
抗凝药
血小板聚集抑
制剂
Carotid stenosis
Aneurysm, dissecting
Angiography, digital subtraction
Anticoagulants
Platelet aggregation inhibitors
