目的 探讨无颈动脉重度狭窄或 闭塞患者Willis环形态学特征与急性缺血 性脑中风的相关性。方法 回顾性分析75 例AIS患者COW形态特征，根据有无CA狭窄 分为CA重度狭窄或闭塞AIS 35例(Ⅰ组)和 无CA重度狭窄或闭塞AIS 40例(Ⅱ组)，并 纳入35例无脑梗死患者(Ⅲ组)进行对照， 采用χ2检验和Bonferroni校正χ2检验对 COW形态分型、血管发育情况、供血动脉 病变进行分析，采用Pearson相关分析评 估以上诸因素与AIS的关系，采用多变量 logistic回归分析影响AIS的危险因素。 结果 三组间COW形态分型及前交通动脉、 大脑前动脉第一段、大脑后动脉第一段发 育不良、颅内供血动脉病变数、供血动脉 狭窄程度的差异均有统计学意义(χ2分别 为15.84，79.24，16.19，64.19，P值均﹤ 0.05)；Ⅰ组和Ⅱ组间以上诸因素的差异 均无统计学意义(χ2分别为0.68、3.89、 1.81、3.89，P值均﹥0.05)；COW形态分 型、COW血管发育状态与AIS相关系数r分 别为-0.25、-0.16。多因素logistic回归 分析显示不完整COW及ACoA、PCOA变异OR 分别为0.01、6.55、3.19，95%CI：0.00- 0.22、1.69-25.44、1.41-9.60。结论 即使无CA重度狭窄或闭塞，不完整COW及 ACOA、PCOA变异仍为AIS的危险因素。

Objective To investigate the correlation between modality of the circle of Willis (COW)and acute cerebral stroke (AIS) in patients without carotid artery(CA) stenosis or occlusion. Methods The modality of COW in 75 patients with AIS were retrospective analyzed and divided into 35 patients with AIS had severe CA stenosis (group I)and 45 without (group II) according to CA stenosis, and 35 patients without cerebral infarction patients (Group III) were compared. Variables including the state type of COW, vascular development, feeding artery disease were analyzed by χ2 test and Bonferroni correction χ2 test. The relationship between AIS and vascular development were analyzed by pearson correlation analysis. Logistic regression was used to estimate potential risk factors for AIS. Results The differences of Three groups in COW state type and anterior communicating artery(ACoA), A1 segment of the anterior cerebral artery(ACA-AI), P1 segment of the posterior cerebral artery (PCA-PI) dysplasia ,and the number of intracranial artery stenosis were statistically significant (χ2=15.84, 79.24, 16.19, 64.19, P<0.05).There was no significant difference between group I and II in the factors (χ2=0.68, 3.89, 1.81, 3.89, P﹥0.05). OR in incomplete COW, ACoA and PCOA variation were 0.01, 6.55, 3.19;95%CI:0.00-0.22, 1.69-25.44, 1.41-9.60. Conclusion In the absence of CA severe stenosis, the incomplete COW, the variation of ACoA and PCOA were still potential risk factors for AIS.