椎开口严重狭窄与后循环缺血的关系  

The Relationship Between Severe Stenosis of Vertebra Artery and Posterior Circulation Ischemia

作　　者：白雪[1] 张晶晶[1] 刘丽[1] 高晓梅[1] 

机构地区：[1]赤峰市医院神经内科,内蒙古赤峰024000

出　　处：《内蒙古医学杂志》2015年第10期1157-1160,共4页Inner Mongolia Medical Journal

摘　　要：目的探讨椎动脉起始处狭窄斑块形态及血流动力学异常对后循环缺血的影响,为后循环缺血的治疗提供决策依据。方法回顾性分析2012年6月至2015年1月我院神经内科住院的椎动脉起始处狭窄≥70%的患者临床资料,依据患者临床表现及头颅MRI或平扫CT结果将全部患者分为卒中组和非卒中组,比较两组间椎动脉起始处斑块形态、性质以及血流动力学影响因素(双侧病变、串联病变、椎动脉基底动脉化、willi环完整性)的差异性。结果共256例合格患者入组,其中男性211例(82.4%),女性45例(17.6%),平均年龄(64.5±8.2)岁。卒中组与非卒中组相比,平均年龄低于非卒中组(62.4 vs 65.5岁),差异有明显统计学意义(P=0.003),并且卒中组患者既往卒中史比例高于非卒中组(23.3%vs 10.6%,P=0.007),差异有统计学意义。卒中组双侧病变患者较非卒中组多(69.8%vs 31.2%),差异有统计学意义(P=0.000);卒中组串联病变患者多于非卒中组(43.0%vs 20.0%),差异有显著统计学意义(P=0.000);卒中组不规则斑块出现率高于非卒中组(46.5%vs 25.9%),两组间比较有明显统计学意义(P=0.001)。结论对于椎动脉起始处≥70%的狭窄患者,双侧椎动脉严重狭窄、串联狭窄、不规则斑块与后循环缺血相关,对此类患者,应予以更积极的治疗。Objective To investigate the influence on posterior circulation ischemia caused by atherosclerotic plaque morphology and hemodynamic disorder,in order to provide influence for the treatment of posterior circulation ischemia.Methods A retrospective research was carried out,in which informations of patients with ≥70% stenosis of vertebral artery ostium were collected and patients were divided into stroke group and non-stroke group according to clinical presentation and head MRI or CT scan,comparing difference of two groups about plaque morphology and nature located vertebral artery ostium,factors affected hemodynamics which include bilateral lesions,tandem lesions,basilarization of vertebral artery and status of the circle of Willis.Results 256 eligible cases including 211 men（82.4%）and 45 women（17.6）were enrolled,the average age is 64.5±8.2 years,there is a statistical difference of average ages between two groups（62.4 years VS 65.5 years,P=0.003）,and stroke group has a higher incidence of previous stroke history（23.3% VS10.6%,P=0.007）.There are statistical difference among two groups about bilateral lesions（69.8% VS 31.2%,P=0.000）,tandem lesions（43.0% vs 20.0%,P=0.000）and irregular plaques（46.5% vs 25.9%,P=0.001）.Conclusion As patients have ≥70% stenosis of vertebral artery,there are significant correlation between bilateral lesions,tandem lesions,irregular plaques and posterior circulation ischemia,more attention should be paid for those patients.

关 键 词：椎动脉狭窄 血流动力学 

分 类 号：R743.3[医药卫生—神经病学与精神病学]