应用MRA研究后交通动脉变异与后循环梗死的相关性  

MRA Study on Correlation of Posterior Communicating Artery Variation and Posterior Circulation Infarction

作　　者：周围[1] 许乙凯 陆敏茹[3] 梁耀基[3] 陈峰[4] 胡秋根[1] 刘健[3] 

机构地区：[1]南方医科大学附属顺德第一人民医院放射科,广东佛山528300 [2]南方医院医学影像中心,广东广州510515 [3]附属顺德第一人民医院康复医学科,广东佛山528300 [4]附属顺德第一人民医院病案统计室,广东佛山528300

出　　处：《中山大学学报（医学科学版）》2016年第2期277-282,共6页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省佛山市科学技术局医学类科技攻关项目(2015AB002553;2014AB002553)

摘　　要：【目的】分析血管形态危险因素,研究后交通动脉变异与后循环梗死的联系。【方法】收集我院776例病历完整的住院患者,其中181例临床确诊后循环梗死者为研究组,另595例无后循环梗死者为对照组。根据三维时间飞跃法磁共振血管成像图像按后交通动脉的影像形态特征归纳为4个临床亚型,并以后交通动脉临床亚型、性别、年龄、高血压、糖尿病及高脂血症为自变量,进行Logistic回归分析后循环梗死的危险因素。【结果】两组患者的后交通动脉的临床亚型构成有显著差异(P=0.004)。对于后循环梗死而言:高血压为危险因素(P<0.001)、高脂血症为危险因素(P=0.015),后交通动脉的临床亚型亦为重要的影响因素(P=0.010),其中B型(仅见单或双侧胚胎性大脑后动脉)为危险因素(P=0.040),发生后循环梗死的风险比D型(无后交通动脉,亦无胚胎性大脑后动脉)高65.4%。【结论】胚胎性大脑后动脉者需要积极预防后循环梗死。[Objective] To analyze risk factors of vascular form, aiming to study the relationship between variation of posterior communicating artery （PCoA） and posterior circulation infarction （PoCI）. [ Methods ] This retrospective analysis contained a total of 776 patients from our hospital, the number of PoCI （research group） and non PoCI （control group） was 181 and 595, respectively. According to three dimensional time of magnetic resonance angiography （3D TOF MRA）, PCoA image characteristic can be divide to 4 clinical subtypes.Apply Logistic regression analysis risk factors of posterior circulation cerebral infarction, used clinical subtypes of PCoA, gender, age, hypertension, diabetes and hyperlipidemia as independent variables. [ Results] The constituent ratio of PCoA clinical subtypes between research group and control group was statistically significant difference （P = 0.004）. For the PoCI, hypertension （P 〈 0.001 ） and hyperlipidemia （P = 0.015）, as well as the clinical subtypes of PCoA （P= 0.010） are the risk factor. We further concluded that the clinical subtypes of PCoA, of which only type B （single or double sides of fetal origin of the posterior cerebral artery） as risk factor P = 0.040） that has more 65.4% risk of the PoCI than type D （neither has PCoA, nor fetal origin of the posterior cerebral artery）. [ Conclusion ] Prevent of PoCI must be more actively if the fetal origin of the posterior cerebral artery was found.

关 键 词：后交通动脉 形态变异 三维时间飞跃法磁共振血管成像 后循环梗死 危险因素分析 

分 类 号：R445.2[医药卫生—影像医学与核医学]