椎动脉优势对基底动脉弯曲影响及其与后循环脑梗死发生率关系  

Effect of vertebral artery dominance on basal artery bending and its relationship with the incidence ofposterior circulation infarct

作　　者：李薇[1] 李军[1] 苏杭[1] 李莉莉[1] 宋士萍[1] LI Wei;LI Jun;SU Hang;LI Li-li;SONG Shi-ping(Department of Neurology,Beijing Chuiyangliu Hospital,Beijing 100022,China)

机构地区：[1]北京市垂杨柳医院神经内科,北京100022

出　　处：《临床军医杂志》2018年第7期749-751,共3页Clinical Journal of Medical Officers

摘　　要：目的探讨椎动脉优势(VAD)对基底动脉形态学改变影响以及其与后循环各部位梗死发生率的关系。方法选取自2015年7月至2016年6月北京市垂杨柳医院神经内科收治的106例急性后循环脑梗死患者为研究对象。根据VAD判断标准将所有患者分为VAD组(n=67)和非VAD组(n=39)。比较两组患者基底动脉弯曲情况、后循环各部位梗死发生率,分析VAD侧与梗死部位关系。结果 VAD组基底动脉重度弯曲比例为59.7%(40/67),显著高于非VAD组的28.2%(11/39),两组比较,差异有统计学意义(P<0.05)。VAD组患者延髓、脑桥、小脑半球下部梗死发生率均显著高于非VAD组,两组比较,差异均有统计学差异(P<0.05)。延髓、小脑半球下部梗死多发生于VAD侧对侧,桥脑梗死部位多发生于VAD侧同侧。结论 VAD易导致基底动脉向VAD对侧弯曲,易导致延髓、桥脑、小脑半球下部梗死。Objective To investigate the effect of vertebral artery dominance（ VAD） on the morphological changes of basilar artery and the relationship with the incidence of infarction in various parts of posterior circulation. Methods A retrospective study was performed on 106 cases of patients with acute posterior circulation infarction who were admitted from July 2015 to June 2016. According to the VAD judgment criteria,patients were divided into the VAD group（ n = 67） and the non-VAD group（ n = 39）. The relationship between VAD side and infarction site was analyzed by comparing the bending condition of basilar artery and the incidence rate of infarction in various parts of posterior circulation between the two groups of patients. Results The ratio of severe basilar artery bending in the VAD group was 59. 7%（ 40/67）,which was significantly higher than that in the non-VAD group（ 28. 2%,11/39）. The difference between the two groups was statistically significant（ P〈0. 05）. The incidence of the medullary,cerebellopontine and cerebellar hemispheres infarction in the VAD group was significantly higher than that in the non-VAD group（ P〈0. 05）. Infarction in the lower part of the medullary and cerebellar hemispheres occurred mostly on the opposite side of VAD,and on the same side of VAD. Conclusion VAD is more likely to lead to basal artery to the lateral bending,which is liable to cause infarction in the medulla oblongata parts,pons and lower cerebellar hemisphere.

关 键 词：椎动脉优势 基底动脉弯曲 后循环脑梗死 

分 类 号：R543.5[医药卫生—心血管疾病]