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目的探讨急性前循环脑梗死患者颅内外血管功能状态与神经功能缺损的关系。方法前瞻性地对106例首次发病72h内的急性前循环脑梗死患者的经颅多普勒(TCD)检查结果,分为:正常组、颅内血管狭窄组、颅外血管狭窄组、颅内颅外合并狭窄组等四组。对其临床神经功能缺损进行NIHSS评分,比较分析各组神经功能缺损评分间的差异。结果正常组临床神经功能缺损最少,第1日和第21日NIHSS评分分别为4.15和3.28分,预后较好;其次为颅内动脉狭窄组、颅外动脉狭窄组(7.03和6.55分);颅内颅外合并狭窄组神经功能缺损最严重(9.8和9.9分),预后最差。伴有颅内颅外血管狭窄的脑梗死者更易发生进展性卒中。结论对急性前循环脑梗死患者在发病72h内给予TCD检查,可以对颅内颅外血管的功能状态有一个初步的了解,与患者临床表现、治疗、预后有关。
Objective To investigate the relationship between extracranial vascular function and neurological deficits in patients with acute anterior circulation cerebral infarction. Methods The results of transcranial Doppler (TCD) examination of 106 patients with acute anterior circulation cerebral infarction for the first time within 72 hours were prospectively analyzed and divided into three groups: normal group, intracranial stenosis group, extracranial vascular stenosis group, intracranial Extracranial stenosis group and other four groups. NIHSS scores of clinical neurological deficit were compared, and the differences between the neurological deficit scores of each group were compared. Results The clinical neurological deficits in the normal group were the least, NIHSS scores were 4.15 and 3.28 on the 1st and 21st days, respectively, with a good prognosis, followed by intracranial arterial stenosis group, extracranial arterial stenosis group (7.03 and 6.55), cranial The intracranial extracranial stenosis group had the most severe neurological deficits (9.8 and 9.9) with the worst prognosis. Progressive stroke is more likely to occur in cerebral infarcts with intracranial extracranial vascular stenosis. Conclusions TCD examination within 72 hours after onset of acute anterior circulation cerebral infarction may have a preliminary understanding of the functional status of intracranial extracranial vessels, which is related to the clinical manifestation, treatment and prognosis of patients.