椎动脉优势对老年后循环短暂性脑缺血发作患者近期预后的分析  

Effect of vertebral artery dominance on short-term outcome in elderly patients with posterior circulation transient ischemic attack

作　　者：曹利民[1] 李红琴[1] 王洪生[1] 胡志诚[1] 

机构地区：[1]杭州市萧山区中医院神经内科,311201

出　　处：《中华老年心脑血管病杂志》2015年第4期372-374,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：浙江省中医药(中西医结合)重点学科建设计划资助(2012-XK-D01);萧山区科技局社会发展类重大项目(2012449)

摘　　要：目的研究椎动脉优势对老年后循环短暂性脑缺血发作(TIA)患者近期预后的影响。方法前瞻性选择老年后循环TIA患者108例,其中椎动脉优势70例,非椎动脉优势38例,根据ABCD2评分脑梗死危险分层分为低危组31例,中危组65例,高危组12例,比较各组椎动脉磁共振血管成像、临床资料ABCD2评分,7d内脑梗死发生率。结果 108例TIA患者7d内进展为脑梗死者31例(28.7%)。中危组和高危组7d内脑梗死发生率明显高于低危组(30.8%,66.7%vs 9.7%,P<0.05,P<0.01),高危组7d内脑梗死发生率明显高于中危组(P<0.05);椎动脉优势患者7d内脑梗死发生率较非椎动脉优势患者明显增高(35.7%vs 15.8%,P<0.05);ABCD2评分<4分中,椎动脉优势与非椎动脉优势患者7d内发生脑梗死比较,无显著差异(P>0.05);ABCD2评分≥4分中,椎动脉优势患者7d内发生脑梗死较非椎动脉优势患者增高(47.9%vs 17.2%,P<0.05)。结论椎动脉优势为导致后循环TIA后脑梗死的危险因素之一;ABCD2评分中高危患者椎动脉优势的风险尤为明显。Objective To study the effect of vertebral artery dominance on the short-term outcome in elderly patients with posterior circulation transient ischemic attack（TIA）.Methods One hundred and eight elderly posterior circulation TIA patients（70with vertebral artery dominance and38 without vertebral artery dominance）were divided into low risk group（n=31）,moderate risk group（n=65）and high risk group（n=12）according to their ABCD2 score.Their vertebral artery magnetic resonance angiography,clinical data,ABCD2 score and incidence of ischemic stroke within 7days were compared.Results Of the 108 TIA patients,31（28.7%）progressed to ischemic stroke within 7days.The incidence of ischemic stroke was significantly higher in moderate and high risk groups than in low risk group（30.8%vs 9.7%,66.7%vs 9.7%,P〈0.05,P〈0.01）,in high risk group than in low risk group（P〈0.01）,and in patients with vertebral artery dominance than in those without vertebral artery dominance（35.7%vs 15.8%,P〈0.05）.However,the incidence of ischemic stroke was significantly higher in patients with vertebral artery dominance than in those without vertebral artery dominance when their ABCD2 score was ≥4（47.9%vs 17.2%,P〈0.05）.Conclusion Vertebral artery dominance is one of the risk factors for posterior circulation TIA.The risk to develop posterior circulation TIA is particularly high in high risk patients when their ABCD2 score is≥4.

关 键 词：椎动脉 脑缺血发作 短暂性 磁共振血管造影术 脑梗死 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]