动脉粥样硬化相关性缺血性脑血管病408例数字减影血管造影分析  

Analysis of 408 Cases of Atherosclerosis-related Ischemic Cerebrovascular Disease by Digital Subtraction Angiography

作　　者：叶强[1] 黄海波[1] 范良好[2] 章云军[2] 伍晓扬[2] 王金凤[2] 

机构地区：[1]温州医学院附属第一医院脑血管科,浙江省温州市325000 [2]温州医学院附属第一医院介入科

出　　处：《中国全科医学》2010年第8期837-840,共4页Chinese General Practice

摘　　要：目的采用数字减影血管造影(DSA)探讨颅内外供血动脉中重度狭窄或闭塞的临床特点。方法回顾性分析408例动脉粥样硬化相关性缺血性脑血管病患者的DSA资料;分为脑梗死组和短暂性脑缺血发作(TIA)组。结果408例患者中,247例(60.5%)存在脑供血动脉中重度狭窄或闭塞,共存在398处中重度狭窄或闭塞,主要累及颈内动脉起始段(23.4%)、大脑中动脉M1段(17.8%)、椎动脉V1段(16.8%);青年组和中年组单纯颅内动脉累及分别为5例(71.4%)和40例(54.8%),均显著高于老年组(49例,29.3%),差异有统计学意义(P<0.05);单纯颅内动脉累及组的平均年龄〔[(60.2±10.1)岁〕显著低于单纯颅外动脉累及组〔(66.9±8.9)岁〕和颅内外动脉均累及组〔(64.3±9.1)岁〕,差异有统计学意义(P<0.05);颅内外动脉均累及组的胆固醇水平〔(5.0±1.2)mmol/L〕显著高于单纯颅外动脉累及组〔(4.4±1.0)mmol/L〕,差异有统计学意义(P<0.05);单纯颅外动脉累及组合并嗜烟史者65例(59.1%),显著高于单纯颅内动脉累及组(37例,40.2%),差异有统计学意义(P<0.01)。结论颈内动脉起始段、大脑中动脉M1段、椎动脉V1段为脑供血动脉中重度狭窄或闭塞的好发部位;随着年龄的增长,颅外动脉受累所占比例明显增多;嗜烟史对颅外动脉影响更大。Objective To analyze the clinical characteristics of cerebral artery Moderate and severe stenosis or occlusion by Digital subtraction angiography（DSA）.Methods The data of DSA of 408 patients with atherosclerosis-related ischemic cerebrovascular disease were analyzed Retrospectively,which were divided into cerebral infarction group and transient ischemic attack（TIA） group.Results 408 patients,247 cases（60.5%） had moderate and severe cerebral artery stenosis or occlusion,there is a total of 398 moderate and severe stenosis or occlusion,mainly involving initial segment of internal carotid artery（23.4%）,M1 segment of middle cerebral artery（17.8%）,V1 segment of vertebral artery（16.8%）;Of youth group and middle-aged group,the cases involving intracranial artery only were five（71.4%） and 40（54.8%） respectively,significantly higher than the older group（49 cases,29.3%）（P〈0.01;P〈0.05）;the average age of cases involving intracranial artery only was 60.2±10.1 years,significantly lower than that of cases involving extracranial artery only which was 66.9±8.9 years and that of cases involving intracranial artery and extracranial artery which was 64.3±9.1 years（P〈0.01;P〈0.05）;the average TC level of cases involving intracranial artery and extracranial artery is 5.0±1.2mmol/L,significantly higher than that of cases involving extracranial artery only which was 4.4±1.0 mmol/L（P〈0.05）;65 patients involving extracranial artery only had tobacco history（59.1%）,significantly higher than that of cases involving intracranial artery only（37 cases,40.2%）（P〈0.01）.Conclusion The predilection sites of moderate and severe cerebral artery stenosis or occlusion is internal carotid artery,M1 segment of middle cerebral artery and V1 segment of vertebral artery;with age increasing,the proportion of cases involving extracranial artery is increasing markedly;tobacco history has greater impact on the extracranial artery.

关 键 词：数字减影血管造影 动脉粥样硬化相关性缺血性脑血管病 脑梗死 短暂性脑缺血发作 

分 类 号：R743.3[医药卫生—神经病学与精神病学]