目的 观察缺血性脑血管病患者脑血管造影显示的血管狭窄或闭塞的比率及分布;探讨缺血性脑血管病与侧支循环代偿的关系, 为动脉狭窄的诊断和干预提供依据。方法 回顾性分析138例经CT或MRI筛选的缺血性脑血管病患者的DSA资料。分析血管狭窄部位、受累血管数目、血管狭窄形态及侧支循环代偿。结果 血管造影检测出颅内外血管病变患者102例(73.91％), 共累计血管病变有268处。前循环受累158处, 后循环受累93处, 锁骨下动脉(SUB)受累17处。102例狭窄或闭塞患者中, 脑梗死组与TIA组动脉病变分布差异无统计学意义(P> 0.05)。血管狭窄或闭塞与前循环症状相关65例, 占65.66％;与后循环症状相关28例, 占71.79％。47例严重狭窄或闭塞患者中有39例出现明显代偿, 其中仅前交通开放9例, 仅后交通开放13例, 前后交通同时开放17例, 合并其他代偿途径4例。结论 动脉血管病变在缺血性脑血管病中起重要作用。血管狭窄或闭塞与临床症状有密切联系。侧支循环代偿在动脉狭窄或闭塞患者中起着重要作用, 其对决定是否进行干预治疗有重要意义。

Objective To evaluate the frequency and localization of the involved arteries in ischemic cerebrovascular disease by cerebral vascular angiography; to study the relationship between collateral circulation and ischemic cerebrovascular disease. Methods The DSA of 138 patients with ischemic cerebrovascular disease recruited by CT or MRI scan were reviewed. The degree of stenosis, the localization, numbers of the arteries involved, the morphology of artery stenosis and compensatory collateral circulation were assessed. Results There were 102 patients with extracrania1 and/or intracrania1 arteries damage and 268 lesions involved in which the carotid arteries were damaged. 158 lesions involved in anterior circulation, 93 lesions involved in posterior circulation, 17 lesions with SCA. Distribution of lesions was not significantly different between cerebral infarction and TIA. Vascular stenosis or occlusion associated with anterior circulation symptoms were exhibited in 65 cases(65.66％), those with posterior circulation symptoms were in 28 cases(71.79％). There were 47 patients who suffered severe stenosis or occlusion, 39 patients had collateral circulation. 9 had only ACOA open, 13 had only PCOA open, 17 had ACOA and PCOA open, 4 had other collateral circulation. Conclusions Arteral lesions plays an important role in ischemic cerebrovascular disease. Arterial stenosis or occlusion have important relations with clinical symptoms. Collateral circulation plays an important role in patients with arterial stenosis or occlusion, and guides the treatment.