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烟雾病和动脉粥样硬化性颈动脉闭塞患者颅内外旁路手术后颞浅动脉血流和脑血流动力学的变化。

Changes in superficial temporal artery blood flow and cerebral hemodynamics after extracranial-intracranial bypass surgery in moyamoya disease and atherothrombotic carotid occlusion.

机构信息

Department of Cerebrovascular Disease, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.

出版信息

J Neurol Sci. 2013 Feb 15;325(1-2):10-4. doi: 10.1016/j.jns.2012.11.006. Epub 2012 Dec 7.

DOI:10.1016/j.jns.2012.11.006
PMID:23228360
Abstract

This study included 40 consecutive patients with athrothrombotic carotid occlusive disease (A-group) and 13 consecutive patients with moyamoya disease (M-group) who had an internal carotid artery occlusion and underwent EC-IC bypass. Flow velocity and diameter of the operated STA on duplex ultrasonography (STDU), as well as regional cerebral blood flow (rCBF) on single photon emission computed tomography (SPECT) were measured before, 14days after, and 3months after EC-IC bypass. The postsurgical changes in the ipsilateral STA mean flow velocity (MFV) were significantly higher (p=0.0030) and those in the rCBF in the MCA territory were relatively higher (p=0.0936) in the M-group than the A-group patients. On 14days after EC-IC bypass, the STA MFV (76.0±22.5 vs 55.2±16.5cm/s, p=0.0006) and the rCBF (40.0±8.0 vs 34.2±5.9ml/100g/min, p=0.0065) were significantly higher in the M-group than in the A-group. On 3months after EC-IC bypass, these differences in the STA MFV or the rCBF disappeared. There were no significant differences in the postsurgical STA diameter and the ACZ reactivity between both groups. Changes in the STA MFV as well as the rCBF were higher in moyamoya disease than atherothrombotic carotid occlusive disease in the early phase after EC-IC bypass. The STA MFV is highly correlated with the rCBF after EC-IC bypass.

摘要

这项研究纳入了 40 例动脉粥样硬化性颈动脉闭塞性疾病(A 组)和 13 例颈内动脉闭塞性烟雾病(M 组)患者,这些患者均行颅内外动脉搭桥术,采用双功能超声(STDU)检测手术侧大脑中动脉(MCA)供血区的软脑膜动脉(STA)的流速和直径,单光子发射计算机断层扫描(SPECT)测量局部脑血流(rCBF)。在颅内外动脉搭桥术前后 14 天和 3 个月时,分别测量患侧 STA 的平均流速(MFV)、MCA 区 rCBF 的变化。M 组患者术后 STA 的 MFV 显著升高(p=0.0030),MCA 区 rCBF 相对较高(p=0.0936)。术后 14 天,M 组患者的 STA MFV(76.0±22.5 比 55.2±16.5cm/s,p=0.0006)和 rCBF(40.0±8.0 比 34.2±5.9ml/100g/min,p=0.0065)均显著高于 A 组。术后 3 个月,STA MFV 和 rCBF 的差异消失。两组间术后 STA 直径和大脑中前穿质动脉(ACZ)反应性无显著差异。颅内外动脉搭桥术后早期,烟雾病患者的 STA MFV 和 rCBF 变化均高于动脉粥样硬化性颈动脉闭塞性疾病。术后 STA MFV 与 rCBF 高度相关。

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