缺血性脑卒中患者颅内外脑动脉狭窄的分布及其危险因素分析  

Distribution of intracranial and extracranial atheroscleroses in patients with ischemic stroke and its risk factors

作　　者：黄治飞[1] 朱幼玲[1] 朱双根[1] 周群[1] 翟登月[1] 张文[1] 

机构地区：[1]安徽医科大学第三附属医院合肥市第一人民医院神经内科,230061

出　　处：《中华老年心脑血管病杂志》2015年第5期451-454,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：安徽省科技攻关计划(130lz04066);合肥市医学重点学科资助项目(2013-206号);安徽医科大学科学研究基金(2013xkj047)

摘　　要：目的探讨缺血性脑卒中患者颅内外脑动脉粥样硬化性狭窄的分布特征及其危险因素。方法选择存在颅内外脑动脉粥样硬化性病变的缺血性脑卒中患者155例,按年龄分为中青年组（年龄33-59岁,51例）和老年组（年龄≥60岁,104例）。通过全脑血管造影检查,对颅内外脑动脉狭窄的分布特征及危险因素进行分析。结果155例患者中共有狭窄或闭塞472处,颅内外病变分别以大脑中动脉狭窄及颈内动脉颅外段最易发生。单发脑动脉病变80例（51.6%）,其中单纯颅内动脉病变44例（55.0%）,单纯颅外动脉病变36例（45.0%）;颅内外动脉并存病变75例（48.4%）,其中颅内外动脉串联病变27例（36.0%）。单纯前循环狭窄58例（37.4%）,单纯后循环狭窄19例（12.3%）,前后循环并存狭窄78例（50.3%）。与中青年组比较,老年组单纯颅内动脉狭窄和前循环狭窄明显降低（22.1%vs 41.2%,31.7%vs 49.0%,P〈0.05）。部分患者存在高血压、高脂血症等危险因素与颅内外动脉狭窄分布模式存在相关性。结论颅内外脑动脉狭窄的分布有年龄特征性,随着年龄增长,逐渐以颅内外动脉及前后循环并存狭窄为主。高血压和高脂血症与颅内外动脉并存狭窄有关。Objective To study the distribution of intracranial and extracranial atheroscleroses in patients with ischemic stroke（IS）and its risk factors.Methords One hundred and fifty-five IS patients were divided into 33-59 years old group（n=51）and ≥60years old group（n=104）.They underwent cerebral angiography.The distribution of intracranial and extracranial atheroscleroses in two groups and its risk factors were analyzed.Results A total of 472 atherosclerotic stenoses or occlusions were detected in the 155 IS patients.Middle cerebral artery stenosis and carotid artery stnosis were most common.Of the 80 cases of single cerebral artery stenosis or occlusion44（55.0%）were diagnosed with intracranial artery stenosis,36（45.0%）were diagnosed with extracranial artery stenosis,and 75（48.4%）were diagnosed with coexistence of craniocervical atery stenosis.The incidence of simple intracranial stenosis and anterior circulation stenosis was significantly lower in≥60years old group than in 33-59 years old group（22.1%vs 41.2%,31.7%vs49.0%,P〈0.05）.Hypertension and hyperlipedemia were associated with the distribution of intracranial and extracranial atheroscleroses.Conclusion The distribution of intracranial and extracranial atheroscleroses differes with age.Coexisting extracranial and anterior circulation stenoses gradually become dominant.Hypertension and hyperlipedemia are associated with coexisting extracranial stenosis and anterior circulation stenosis.

关 键 词：卒中 动脉粥样硬化 颅内动脉硬化 脑血管造影术 梗死 大脑中动脉 高血压 高脂血症 

分 类 号：R743.3[医药卫生—神经病学与精神病学]