延髓梗死部位与后循环血管状态的关系  

Correlation between the conditions of posterior circulation and infarctions in medulla

作　　者：邓本立[1,2] 乔亚男[3] 王默力[1] 

机构地区：[1]首都医科大学宣武医院神经内科,北京100053 [2]航天科工集团731医院急诊科,北京1000074 [3]卫生部中日友好医院神经内科,北京100029

出　　处：《中风与神经疾病杂志》2014年第12期1093-1096,共4页Journal of Apoplexy and Nervous Diseases

摘　　要：目的探讨延髓梗死部位与后循环血管状态的关系。方法选择142例经头部MRI确诊为延髓梗死的患者,依据延髓供血动脉分部将其分为5组:(1)内侧组;(2)前外侧组;(3)背外侧组;(4)后侧组;(5)综合组。经CTA和DSA检查观察血管情况。结果各组例数分别为11(7.7%)、16(11.3%)、68(47.9%)、6(4.2%)、41(28.9%)例。左椎动脉闭塞18例(12.7%),狭窄23例(16.2%);右椎动脉闭塞20例(14.1%),狭窄27例(19.0%);双椎动脉闭塞4例(2.8%),狭窄5例(3.5%)。左小脑后下动脉闭塞6例(4.2%),狭窄10例(7.0%);右小脑后下动脉闭塞5例(3.5%),狭窄13例(9.2%)。脊髓前动脉狭窄6例(4.2%)。1组与脊髓前动脉狭窄之间有相关性(P=0.012);2组与基底动脉狭窄、基底动脉闭塞有相关性(P=0.041,0.027);3组与右椎动脉狭窄、右椎动脉闭塞、右小脑后下动脉闭塞均有相关性(P=0.005,0.011,0.032);4组与椎动脉闭塞有相关性(P=0.042);5组与右椎动脉闭塞有相关性(P=0.038)。结论延髓不同部位梗死的发生与后循环相应供血血管狭窄或者闭塞关系密切。梗死机制可能以低灌注为主。Objective To investigate the correlation between the conditions of posterior circulation and infarctions in medulla. Methods We chose 142 inpatient cases who were diagnosed as medullary infarction by MRI. All the cases were divided into five groups including the anteromedial group （ group 1 ）, the anterolateral group （ group 2 ）, the lateral group （ group 3 ）, the posterior group（ group 4 ） and the consolidated group（ group 5 ） according to the branches of the medulla oblongata. Then they were inspected with CTA and DSA. Results In all 142 cases, 11 cases （7.7%） were in group 1,16 cases（ 11.3% ） in group 2,68 eases（47.9% ） in group 3,6 cases（4.2% ） in group 4,41 cases（28.9% ） in group 5.18 cases（ 12.7% ） had the occlusion of left vertebral artery,23 cases（ 16.2% ） had the stenosis of the same artery. 20 cases （ 14.1% ） and 27 eases（ 19.0% ） with right vertebtal artery occlusion and stenosis. 4 cases（2.8% ） had the occlusion of both vertebral artery,5 cases（3.5% ） had the stenosis. 6 cases（4.2% ） and 10 cases（7.0% ） with left posterior inferior eerebellar artery occlusion or stenosis each. 5 cases （3.5%） and 13 cases （9.2%） with fight posterior inferior cerebellar artery occlusion or stenosis. 6 eases（4.2% ） with anterior spinal artery stenosis. Group 1 was related to sienosis of anterior spinal artery（ P = 0. 012 ）. Group 2 was related to stenosis and occlusion of basilar artery（ P = 0. 041,0. 027 ）. Group 3 was related to stenosis and occlusion of the right vertebral artery, and occlusion of the right posterior inferior cerebellar artery（ P = 0. 005 ,0. 011,0. 032 respectively）. Group 4 was related to occlusion of vertebral artery （P = 0. 042 ）. Group 5 was related to occlusion of the right vertebral artery（ P = 0. 038 ）. Group 3 had more relevant with the stenosis of the right vertebral artery than the occlusion. Conclusion There is a significant correlation between stenosis or occlusion of posterior circulat

关 键 词：延髓梗死 椎基底动脉 磁共振成像 数字减影血管造影 

分 类 号：R743.3[医药卫生—神经病学与精神病学]