摘要
目的探讨并比较单侧症状性颈内动脉闭塞(SICAO)与单侧症状性大脑中动脉闭塞(SMCAO)患者行颞浅动脉-大脑中动脉(STA-MCA)旁路移植术后颈动脉多普勒超声(CDU)评估的STA血流动力学、CT灌注(CTP)评估的脑灌注及术后神经功能改善情况,并分析CDU评估的流经STA相对峰值血流量(rPVOL)与颅内相对脑血流量(rCBF)的相关性。方法回顾性连续纳入2019年3月至2022年6月在苏州大学附属第一医院神经外科经DSA和(或)CT血管成像(CTA)确诊为单侧SICAO或单侧SMCAO,行STA-MCA旁路移植术且完成术后360 d随访患者112例,并分为SICAO组(50例)和SMCAO组(62例)。收集SICAO组和SMCAO组患者的一般资料、临床资料及影像学资料。一般资料及临床资料包括年龄、性别、临床诊断(卒中、短暂性脑缺血发作)、高血压病、糖尿病、吸烟史、血生化指标(总胆固醇、三酰甘油、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、超敏C反应蛋白)、入院时和术后7 d美国国立卫生研究院卒中量表(NIHSS)评分以及入院时及术后7、180、360 d的改良Rankin量表(mRS)评分(mRS评分≤2分为预后良好,mRS评分>2分为预后不良)。影像学资料包括行STA-MCA旁路移植术前7 d及术后7、30、180、360 d CDU评估STA的血流动力学参数[STA内径(D)、阻力指数(RI)、时间平均流速(TAMV)和时间平均峰值流速(TAPV)]和术前及术后7、180、360 d内头部感兴趣区(ROI)的CTP参数[rCBF、相对脑血容量(rCBV)、相对平均通过时间(rMTT)、相对达峰时间(rTTP)]。出院后1年,门诊或电话随访患者再发性卒中(短暂性脑缺血发作、脑梗死等)及其他术后并发症(硬膜下血肿、脑出血等)发生情况。术后1年行DSA影像学随访,判断SICAO与SMCAO两组患者血管吻合通畅情况。比较SICAO与SMCAO两组患者行STA-MCA旁路移植术前后各时间点的STA血流动力学参数、头部CTP参数、NIHSS评分与mRS评分;组内比较SICAO与SMCAO每�
Objective To investigate the hemodynamic,cerebral perfusion and neurological function changes between unilateral symptomatic internal carotid artery occlusion(SICAO)and symptomatic middle cerebral artery occlusion(SMCAO)after superfical temporal artery-middle cerebral artery(STA-MCA)bypass surgery as well as the correlation between relative peak volume of blood flow(rPVOL)in STA measured by carotid Doppler ultrasonography(CDU)and relative cerebral blood flow(rCBF)by CT perfusion(CTP).Methods Retrospective analysis of 112 patients who diagnosed with unilateral SICAO or SMCAO through DSA and/or CT angiography(CTA)and underwent superficial temporal artery-middle cerebral artery(STA-MCA)bypass in the Department of Neurosurgery at First Affiliated Hospital of Soochow University from March 2019 to June 2022.The patients were divided into SICAO group(50 cases)and SMCAO group(62 cases)and followed up for 360 days.General clinical and imaging data of patients in two groups were collected.General clinical information included age,gender,clinical manifestations(stroke,transient ischemic attack[TIA]),hypertension,diabetes,smoking history,blood biochemical indicators(total cholesterol,triacylglycerol,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,high-sensitivity C-reactive protein),National Institute of Health stroke scale(NIHSS)scores at admission and 7 days after surgery,and modified Rankin Scale(mRS)scores at admission and 7,180 and 360 days after surgery(mRS scores≤2 as good prognosis,>2 as poor prognosis).Imaging data included hemodynamic parameters(STA diameter[D],resistance index[RI],time-averaged-mean velocity[TAMV],and time-average-peak flow velocity[TAPV])evaluated by CDU within 7 days before and 7,30,180 and 360 days after STA-MCA bypass,as well as CTP parameters(rCBF,relative cerebral blood volume[rCBV],relative mean transit time[rMTT]and relative time to peak[rTTP])of the head region of interest(ROI)before and 7,180 and 360 days after surgery.Patients were observed 1 year after surger
作者
王润川
惠品晶
颜燕红
杨柳
黄亚波
Wang Runchuan;Hui Pinjing;Yan Yanhong;Yang Liu;Huang Yabo(Department of Vascular Ultrasonography,the First Affiliated Hospital of Soochow University,Suzhou 215006,China)
出处
《中国脑血管病杂志》
CAS
CSCD
北大核心
2023年第12期803-815,共13页
Chinese Journal of Cerebrovascular Diseases
基金
苏州市民生科技项目(SS202061)
苏州大学技术合作项目(H211064)。
