缺血性脑血管病96例侧支循环建立多因素分析

摘要

Objective :To investigate the relationship between nerve function deficit and collateral circulation formation and the possible influencing factors .Methods :160 patients with ischemic cerebrovascular disease (ICVD) were selected randomly by retrospective study .According to the collateral circulation formation ,these patients were divided into two group ,collateral circulation formation (n = 94) and unformation group (n = 66) .NIHSS score and volume of cerebral infarction in two groups were observed .Sociology and clinical data including gender ,age ,smok‐ing ,heart cerebrovascular disease ,mean arterial pressure ,diabetes ,number of stenosis blood vessel ,degree of artery stenosis ,blood indicators were univariate analyzed ,then the positive factors were Logistic regression analyzed .Re‐sults :In collateral circulation formation group ,the NIHSS score and volume of cerebral infarction were lower than those in unformation group(P< 0 .05) .Univariate analysis showed that gender ,age ,smoking ,mean arterial pres‐sure ,number of stenosis blood vessel ,degree of artery stenosis ,homocysteine (Hcy)were influencing factors ,while multivariate analysis by Logistic regression showed that smoking ,mean arterial pressure and Hcy were independent influencing factors for patients with ICVD .Conclusion :Collateral circulation has a protective effect on cerebral artery stenosis or occlusion .It may play an important role by reducing the NIHSS score and volume of cerebral infarction . There are close associations between collateral circulation formation and smoking ,mean arterial pressure and Hcy .%目的：探讨缺血性脑血管病患者侧支循环建立情况和神经功能损伤程度的关系并分析影响侧支循环建立的相关因素。方法：对160例缺血性脑血管疾病患者行 DSA 检查，根据侧支循环建立情况分为侧支循环建立组（n＝94）和侧支循环未完全建立组（n＝66），比较两组患者 NIH‐SS 评分和脑梗死体积的差异。同时收集临床病例资料，将可能影响侧支循环建立的因素，包括：性别、年龄、心脑血管病史、糖尿病、平均动脉压、吸烟史、病变血管数量、狭窄程度及相关血液指标等进行单因素分析，然后进行非条件多因素 Logistic 回归分析。结果：侧支循环建立组患者 NIHSS和脑梗死体积明显低于侧支循环未完全建立组，差异有统计学意义（P ＜0．05）。单因素分析显示：性别、年龄、吸烟史、平均动脉压、血管病变的支数、狭窄程度以及血浆同型半胱氨酸和侧支循环建立有关。 Logistic 多因素回归分析显示：吸烟、平均动脉压和血浆同型半胱氨酸是侧支循环建立的独立影响因素。结果：侧支循环的建立对缺血性脑血管疾病有着重要的保护作用，使得患者神经功能损伤明显减轻。吸烟、平均动脉压升高以及血浆同型半胱氨酸和缺血性脑血管患者侧支循环建立密切相关。