摘要
Abstract
Objective To investigate the effect of leptomeningeal anastomoses ( LMA ) compensation on the recurrence of ischemic stroke within one year after onset in cerebral infarction patients with middle cerebral artery( MCA ) atherosclerotic occlusion. Methods We enrolled 112 cerebral infarction patients with unilateral MCA atherosclerotic occlusion who accorded with the inclusion standard and were admitted into the Department of Neurology of Central Hospital of Wuhan from January 2010 to January 2013. The MCA occlusion and LMA compensation were evaluated by MRA. According to the results of one-year follow-up and the compensation degree,the subjects were divided into LAM positive group and LMA negative group;according to the number of compensation pathway,the subjects were also divided into double-pathway compensation group,one-pathway compensation group and no-pathway compensation group. The recurrence of ischemic stroke in follow-up period was compared among all the groups. Results Among the 112 subjects,76 subjects were in LMA positive group,36 subjects were in LMA negative group. There were 10 cases of ipsilateral ischemic stroke recurrence within 1-year follow-up,with a recurrence rate of 8. 9%. Of the 10 cases of recurrence,3 cases( cerebral infarction)were in the LAM positive group,with a recurrence rate of 3. 9%(3/76),and 7 cases(3 cases of cerebral infarction and 4 cases of TIA)were in the LAM negative group,with a recurrence rate of 19. 4%(7/36). The two groups were significantly different in one-year recurrence rate of ischemic stroke (χ2 =7. 220,P=0. 007). There were 34 subjects in double-pathway compensation group,with a recurrence rate of 2. 9%(1/34);there were 42 subjects in one-pathway compensation group,among which 14 subjects were of ACA compensation and 28 were of PCA compensation, with a recurrence rate of 4. 8% ( 2/42 );there were 36 subjects in the no - pathway compensation group, with a recurrence rate of 19. 4% ( 7/36 ). The subjects with different number of LMA compensation pathway were significantly different in the one-year recurrence rate(χ2 =7. 29,P=0. 026). The recurrence group and the non-recurrence group were significantly different(P <0. 05)in the discontinuation rate of antiplatelet drug,and no significant differences were noted in other baseline data between the two groups. Conclusion Among the cerebral infarction patients with MCA occlusion,LMA positive compensation can effectively reduce the incidence of recurrent ischemic stroke within 1 year after onset,and double-pathway LMA is superior to the single-pathway LMA and no-pathway LMA in the protection from recurrent ischemic stroke.关键词
梗死,大脑中动脉/闭塞性动脉硬化/脑血管循环/复发Key words
Infarction,middle cerebral artery/Arteriosclerosis obliterans/Cerebrovascular circulation/Recurrence分类
医药卫生
