The relationship between collateral circulation formation and prognosis in patients with acute cerebral infarction in the territory of internal carotid artery / 中华行为医学与脑科学杂志

ABSTRACT

Objective To analyze the relationship between collateral status and clinical manifestations or prognosis in patients with acute cerebral infarction in the territory of internal carotid artery.Methods 181 patients with acute cerebral infarction in internal carotid arterial were selected.According to the North American Symptomatic Carotid Endarterectomy Trial (NASCET) standard,the degree of carotid stenosis was divided into 5 grades.All patients were divided into 3 subgroups according to the status of collateral circulation formation evaluated with the Regional Lepomeningeal Score(rLMC).The correlations were observed between the degree of carotid stenosis and the compensation level of collateral circulation,and the compensation level of collateral circulation and cerebral infarct volume,and the National Institute of Health Stroke Scale(NIHSS) on admission and the Activity of Daily Living(ADL) score at 3 months after stroke onset.Results The degree of carotid stenosis positively correlated with the compensation level of collateral circulation (r=0.724,P<0.01).The compensation level of collateral circulation negatively correlated with infarct volume (r=-0.313,P<0.01) and NIHSS score on admission (r=-0.504,P<0.01),but positively correlated with ADL score at 3 months after stroke onset (r=0.370,P<0.01).Diabetes was risk factor for the formation of moderate (OR=1.361,95%CI=1.145-1.902,P=0.029) collateral circulation,and hyperlipemia was risk factor for the establishment of moderate (OR=1.050,95%CI=1.011-1.219,P<0.01) or poor (OR=1.048,95%CI=1.010-1.225,P<0.01) collateral circulation.Conclusion The compensation level of collateral circulation positively correlates with the severity of carotid stenosis.Diabetes and Hyperlipemia are risk factors for the formation of collateral circulation.The improvement in the status of collateral circulation can significantly reduce infarct volume and improve prognosis in patients with acute cerebral infarction in the territory of internal carotid artery.