Zhongguo cuzhong zazhi (Dec 2022)
DSA评估无症状大脑中动脉闭塞患者侧支循环状态研究 Digital Subtraction Angiography Evaluation of Collateral Compensation in Asymptomatic Middle Cerebral Artery Occlusion
Abstract
目的 通过DSA观察无症状大脑中动脉闭塞患者的侧支循环代偿状态。 方法 回顾性连续纳入2018年10月-2022年2月邢台市第九医院收治的经DSA确诊的无症状性大脑中动脉闭塞患者（无症状闭塞组），并选择同期经DSA检查确诊为症状性急性大脑中动脉闭塞且进行了血管内治疗的患者作为对照组（症状性闭塞组）。收集患者的人口学信息、血管危险因素。对两组的DSA检查结果进行再评估，采用美国介入治疗神经放射学学会（American Society of Interventional and Therapeutic Neuroradiology，ASITN）/介入放射学学会（Society of Interventional Radiology,SIR）标准评估侧支循环状态。比较两组的ASITN/SIR评分差异。 结果 共纳入39例患者，无症状闭塞组17例，症状性闭塞组22例，症状性闭塞组高同型半胱氨酸血症病史发生率高于无症状闭塞组，两组其余基线资料差异无统计学意义。无症状闭塞组中ASITN/SIR评分2级2例（11.8%）、3级6例（35.3%）、4级9例（52.9%），症状性闭塞组中ASITN/SIR评分0级3例（13.6%）、1级8例（36.4%）、2级6例（27.3%）、3级3例（13.6%）、4级2例（9.1%），两组差异有统计学意义（P<0.001），无症状闭塞组的侧支循环代偿更优。 结论 无症状大脑中动脉闭塞患者比症状性大脑中动脉闭塞患者具有更好的侧支循环代偿。 Abstract: Objective To observe the collateral compensation based on DSA in patients with asymptomatic middle cerebral artery (MCA) occlusion. Methods This retrospective study enrolled the consecutive inpatients with asymptomatic MCA occlusion diagnosed by DSA in Xingtai Ninth Hospital from October 2018 to February 2022, which were taken as asymptomatic occlusion group; the acute symptomatic MCA occlusion inpatients based on DSA who underwent endovascular treatment at the same time period were enrolled as the control group (symptomatic occlusion group). The baseline information of the two groups were collected. Collateral circulation were assessed using the American Society of Interventional and Therapeutic Neuroradiology (ASITN) / Society of Interventional Radiology (SIR) based on DSA. Differences in ASITN/SIR scores of the two groups were compared. Results A total of 39 patients were enrolled, with 17 in asymptomatic occlusion group and 22 in symptomatic occlusion group. The proportion of hyperhomocysteinemia in symptomatic occlusion group was higher than that in asymptomatic occlusion group, and there were no statistical differences in the other baseline data between the two groups. In the asymptomatic occlusion group, 2 cases (11.76%) with ASITN/SIR grade 2, 6 cases (35.29%) with grade 3, 9 cases (52.94%) with grade 4; in the symptomatic occlusion group, 3 cases (13.36%) with ASITN/SIR grade 0, 8 cases (36.4%) with grade 1, 6 cases (27.3%) with grade 2, 3 cases (13.6%) with grade 3, 2 cases (9.1%) with grade 4, with statistical differences between the two group, which indicated that the asymptomatic group had a better collateral compensation ability. Conclusions The patients with asymptomatic MCA occlusion have a better collateral compensation than patients with symptomatic MCA occlusion.
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