| Objects: The vertebral artery of patients with posterior circulation ischemic stroke was observed by fine flow imaging(Fine Flow).The patients were divided into observation group and control group according to the presence or absence of collateral compensation.The clinical data of the patients were summarized and statistically analyzed.The posterior complement of posterior vertebral artery occlusion was influenced by the prognosis and long-term quality of life of posterior circulation ischemic stroke.The most common pathways of collateral formation after vertebral artery occlusion were summarized.The significance of collateral compensation in patients with post-circulation ischemic stroke and the significance of long-term quality of life.Methods: 1.We collected 217 cases with posterior circulation cerebral ischemia from June 2014 to December 2016 Tianjin Hospital,Department of Neurology.1.collected from June 2014 to December 2016 Tianjin Hospital,Department of Neurology.Inclusion criteria:(1)the presence of posterior circulation of the symptoms and signs of the blood,confirmed by the skull MR examination,age,male and female,the patient in line with 2014,"China after the issue of ischemia experts consensus" proposed diagnostic criteria for posterior circulation infarction;(2)carotid ultrasonography prompted vertebral artery occlusion with contralateral vertebral artery severe stenosis,in line with the "Chinese stroke vascular ultrasound guidelines";(3)within 1 week of onset,vital signs were stable;(4)positive patients With follow-up follow-up;exclusion criteria:(1)TIA attack patients;(2)had history of drug abuse or mental illness;(3)suffering from severe medical diseases and heart disease patients.(Age,sex,onset time,length of hospital stay)and clinical related factors [(hypertension,diabetes,hyperlipidemia and other medical history and alcohol and tobacco and other bad habits(smoking history ≥ 5 years,≥10 pieces each day,drinking history ≥ 5 years,the average daily drinking ≥ 50ml),Patients were enrolled in the hospital after the completion of the relevant examination(head nuclear magnetic,head and neck blood vessels CTA,carotid artery color Doppler ultrasound,transcranial Doppler,etc.),and according to the National Institutes of Health Stroke Scale(National Institute of Health stroke scale)(Barthel score)and improved Ranking score were scored on the patients,and the patients were divided into control group according to the results of ultrasound and high blood flow imaging(no vertebral artery And the observation group(vertebral artery occlusion of the lateral branch compensatory),the two groups of patients with vertebral artery occlusion ipsilateral carotid artery velocity and resistance index were measured records;all patients during hospitalization to give standardized treatment measures and nursing measures,after the onset of the patient Continue to follow up.(NIHSS score),Barthel Index(BI)and modified Ranking score(MRS)were recorded and recorded in the two groups after the onset of January,March and 1 year respectively.All the scores were analyzed at.2.Patients with all the observation groups were grouped according to the results of the ultrasonography.Only the ultrathin blood flow signal(very low flow rate or low flow rate)was included in the low-speed blood flow group(ie,the compensatory insufficiency),and the ultrasonography(NIHSS score),life function score(Barthel score)were measured in the low flow rate group and the normal flow group(P <0.05).The patients were divided into normal flow group(compensatory group),BI)and modified Ranking Score(MRS)were used to analyze whether the formation of collateral responses was sufficient to predict the prognosis and long-term quality of life of stroke patients.Results: 1.A total of 217 patients with posterior circulation ischemia were hospitalized in Tianjin Huanhu Hospital.After hospitalization,the ischemic stroke caused by posterior circulation ischemia was confirmed.After screening,the number of standard cases(Control group,51.56 ± 14.88 VS observation group 49.06 ± 17.94,P> 0.05),gender(group,control group,age group,age group,age group,age group,(P <0.05),the onset time(hour,control group,3.17 ± 2.01VS3.45 ± 2.89,P> 0.05),body mass index(23.91 ± 3.96VS23.51 ± 4.01)(P <0.05)and the number of days of hospitalization(days,14.70 ± 5.97VS16.01 ± 8.11,P> 0.05)were not statistically significant in the patient’s previous history(hypertension,diabetes,hyperlipidemia,etc.)Smoking,drinking,etc.).After hospitalization,the patients were examined by imaging(head and neck vascular CTA,carotid color Doppler ultrasonography,etc.).In the observation group,34 cases of CTA were found in 15 cases of lateral carotid artery occlusion,Patients only visible vertebral artery occlusion,no collateral compensatory vascular imaging.The control group of 49 patients with CTA results in the vertebral artery occlusion side showed no branch compensatory formation.NIHSS score,Barthel Index and MRS score were scored within 24 hours after hospitalization.There was no significant difference between the observation group and the control group [NIHSS score(13.07 ± 5.01VS14.91 ± 6.11,P> 0.05),BI(44.75 ± 15.05VS44.91 ± 16.22,P> 0.05)and MRS score(4.31 ± 1.75VS4.29 ± 1.38,P> 0.05).The neurological deficit score was again(NIHSS score),life ability score(Barthel score)and MRS score,the observation group score was significantly better than the control group [NIHSS score(10.47 ± 4.83VS9.03 ± 3.98,P <0.05),BI(50.17 ± 13.84VS61(P <0.05),and the difference was statistically significant(P <0.05),and the difference was statistically significant(P <0.05).The scores of the scores in the observation group were significantly better than those in the control group at the onset of 3 months(4.53 ± 2.05VS3.29 ± 1.84,P <(58.06 ± 13.18VS79.16 ± 11.84,P <0.05),MRS score(3.94 ± 2.32VS2.62 ± 2.41,P <0.05),NIHSS score(8.17 ± 3.18VS5.07 ± 2.99,P <0.05),The difference was statistically significant,the incidence of 1 year observation group score was significantly better than the control group [NIHSS score(6.01 ± 2.77VS2.14(P <0.05),BI(70.17 ± 19.64VS87.15 ± 21.53,P <0.05),MRS score(3.79 ± 2.51VS1.81 ± 1.99,P <0.05),the difference was statistically significant;(0.71 ± 0.14VS0.82 ± 0.21,P <0.05),and the blood flow resistance index of the external carotid artery was lower than that of the control group(114.17 ± 24.87VS86.16 ± 19.26,P <0.05)The difference was statistically significant.The age of the patients in the low-flow group and the normal-flow group was significantly higher than that in the control group(48.86 ± 15.91 VS observation group,50.98 ± 20.91,P> 0.05),sex(male,control group 8(22.59 ± 6.52VS23.31 ± 7.55,P> 0.05),the body mass index(22.59 ± 6.52VS23.31 ± 7.55,P> 0.05),the onset time(hour,the control group was 3.61 ± 2.14VS3.78 ± 1.99,P> 0.05)(High blood pressure,diabetes mellitus,hyperlipidemia,etc.)and bad habits(smoking,drinking,etc.)were not statistically significant,and the number of hospitalizations(days,17.14 ± 5.41VS16.23 ± 7.14,P> 0.05)And so on were not statistically significant(Table 3).(44.73 ± 16.64VS46.24 ± 18.01,P> 0.05),and the MRS score(4.36 ± 2.01VS4)was significantly higher than that of the control group(P <0.05),but there was no significant difference between the two groups(NIHSS score(15.12 ± 6.08VS14.81 ± 6.43,P> 0.05).18 ± 1.85,P> 0.05)](Table 4).The patients were followed up for 1 year,and the scores of neurological deficits(NIHSS score),life ability score(BI)(P <0.05),BI(53.87 ± 19.33VS68.72 ± 16.63,P <0.05),and the MRS score(3.19 ± 1.17)was significantly lower than that of the low flow rate group [NIHSS score(13.76 ± 5.71VS9.49 ± 5.38,P <(0.13.5 ± 17.76VS78.16 ± 15.22,P <0.05).The scores of NIHSS score(8.03 ± 2.98VS6.14 ± 3.55,P <0.05)were significantly higher than those in the control group(P <0.05)0.05).MRS score(2.08 ± 1.27VS3.21 ± 1.73,P<0.05)was statistically significant.There was no statistical difference between the two groups at 1 year after onset [NIHSS score(3.07 ± 2.24VS3.01 ± 2.71(P <0.05),BI(87.45 ± 23.34VS81.66 ± 23.17,P> 0.05),MRS score(1.99 ± 2.01VS2.23 ± 2.17,P> 0.05).Conclusion: 1.Fine Flow imaging technology can clearly show low-speed collateral compensatory blood flow,through the ultrasonography imaging technique to determine whether the formation of collateral to determine the prognosis of patients to guide further treatment and follow-up;2.Posterior circulation infarction,the formation of lateral branch compensation for the prediction of the patient’s condition and prognosis is of great significance.Collateral compensatory can be a good for the vertebral artery and basilar artery to provide blood flow to a certain extent,ease the posterior circulation of ischemic symptoms,improve the prognosis of patients with posterior circulation;3.Posterior circulation of ischemic stroke in patients with vertebral artery occlusion after ipsilateral external carotid artery can be compensated by the lateral branch of the occlusion of the vertebral artery blood supply,suggesting that the ipsilateral external carotid artery in the vertebral artery occlusion after the formation of the process of compensatory An important role;4.In the vertebral artery occlusion after the formation of the side of the compensatory patients,regardless of collateral compensatory adequacy or not,the patient’s condition and prognosis no significant difference,that is,as long as there is collateral compensatory,regardless of whether the compensatory blood vessels are sufficient Prognosis and long-term quality of life was no significant difference 5.Due to the small number of studies in this study,it is necessary to further expand the sample size. |
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