一级侧支循环数目与颈动脉狭窄术后灌注相关性研究
Study on the Relationship between the Number of Primary Collateral Circulation and Perfusion after Carotid Stenosis
摘要: 目的：利用动脉血质子自旋标记成像技术(Proton spin labeled Perfusion Imaging of Cerebral Arterial Blood, ASL)技术，探究一级侧支循环数目与颈动脉内膜剥脱术(carotid endarterectomy, CEA)术后脑血流量(cerebral blood flow, CBF)和过度灌注状态发生的相关性研究。方法：通过患者病例资料，获得患者术前、术后1.5 s的CBF的改善率，患者脑内一级侧支循环动脉的数目，患者术前术后临床表现。利用统计学分析患者一级侧支循环动脉数目与术后CBF改善率和术后过度灌注状态的发生的相关性。结果：28例患者颈动脉狭窄均得到改善。患者术侧、健侧1.5 s的CBF改善率均有统计学意义(P < 0.05)，且术侧改善率明显大于健侧(P < 0.05)。术侧一级侧支循环数目与1.5 s CBF改善率的表达呈正相关(r= 0.593, P < 0.05)；一级侧支循环数目与过度灌注状态的发生之间表达呈正相关，(r = 0.653, P < 0.05)。结论：患者一级侧支循环动脉数目越多，术后CBF改善越明显，发生过度灌注几率越大。
Abstract: Objective: To explore the relationship between the number of primary collateral circulation and cerebral blood flow (flow, CBF) after carotid endarterectomy (carotid endarterectomy, CEA) by using arterial blood proton spin labeling technique (Proton spin labeled Perfusion Imaging of Cerebral Arterial Blood, ASL). And to explore the correlation between the number of primary collateral circulation and the occurrence of hyperperfusion state. Methods: Through the case data of the patients, the improvement rate of 1.5 s CBF before and after operation, the number of primary collateral arteries in the brain and the clinical manifestations of the patients before and after operation were obtained. Statistical analysis was used to analyze the correlation between the number of primary collateral arteries and the improvement rate of postoperative CBF and the occurrence of postoperative hyperperfusion. Results: Carotid artery stenosis was improved in 28 patients. The CBF improvement rate of 1.5 s in the operative side of the patients was statistically significant (P < 0.05), but there was no significant difference in the contralateral side (P > 0.05). There was a positive correlation between the number of primary collateral circulation and the improvement rate of 1.5 s CBF (r = 0.593, P < 0.05), and between the number of primary collateral circulation and the occurrence of hyperperfusion (r = 0.653, P <0.05). Conclusion: The more the number of primary collateral arteries in patients, the more obvious the improvement of postoperative CBF and the higher the incidence of overperfusion.
文章引用：管仁航, 张竹青, 栗世方. 一级侧支循环数目与颈动脉狭窄术后灌注相关性研究[J]. 临床医学进展, 2020, 10(6): 1065-1073. https://doi.org/10.12677/ACM.2020.106161

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