椎动脉发育不良与后循环脑梗死分布关系分析  

Association between vertebral artery hypoplasia and posterior circulation infarction

作　　者：徐萌萌 王玉洁[1] 辛岳[1] 武青 叶慧茸 王健[1] Xu Mengmeng;Wang Yujie;Xin Yue;Wu Qing;Ye Huirong;Wang Jian(Department of Neurology,Liaoning Provincial People＇s Hospital,Shenyang 110016,Liaoning Province,China)

机构地区：[1]辽宁省人民医院神经内科,沈阳110016

出　　处：《中华老年心脑血管病杂志》2018年第8期832-835,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨椎动脉发育不良(vertebral artery hypoplasia,VAH)与后循环脑梗死分布的关系。方法回顾性分析急性后循环脑梗死患者229例,根据有无VAH分为VAH组116例和非VAH组113例,比较2组间临床及影像特点;同时分析VAH同侧和VAH对侧后循环脑梗死分布的关系。结果 VAH组合并胚胎型大脑后动脉(FTP)比例高于非VAH组(28.45%vs 10.62%,P=0.001);VAH组同侧近段梗死和颅内段椎动脉狭窄发生率显著高于VAH对侧(15.52%vs 6.90%,P=0.003;10.34%vs 2.59%,P=0.016);logistic回归分析显示,VAH组合并FTP的概率较非VAH组高(OR=2.932,95%CI:1.403~6.130,P=0.004);VAH组同侧近段梗死和颅内段椎动脉狭窄的发生率均高于VAH对侧(OR=4.397,95%CI:1.417~13.642,P=0.010;OR=11.996,95%CI:2.083~69.087,P=0.005);VAH组同侧基底动脉弯曲凸向多于VAH对侧(OR=4.076,95%CI:2.236~7.431,P=0.000)。结论 VAH同侧较VAH对侧后循环近段梗死发生率高。Objective To study the association between vertebral artery hypoplasia（VAH）and acut posterior circulation infarction（APCI）.Methods Two hundred and twenty-nine APCI patients were divided into VAH group（n=116）and non-VAH group（n=113）.Their clinical and imaging characteristics were compared.The APCI distribution in both ipsilateral and contralateral VAH was analyzed.Results The incidence of fetal-type posterior cerebral artery（FTP）was significantly higher in VAH group than in non-VAH group（28.45% vs 10.62%,P=0.001）.The incidence of ipsilateral VAH proximal territory infarction and intracranial vertebral artery stenosis was significantly higher than that of contralateral VAH territory infarction（15.52% vs6.90%,P=0.003;10.34% vs 2.59%,P=0.016）.Logistic regression analysis showed that the probability of FTP was higher in VAH group than in non-VAH group（OR=2.932,95%CI：1.403-6.130,P=0.004）.The incidence of ipsilateral VAH proximal territory infarction and intracranial vertebral artery stenosis was higher than that of contralateral VAH proximal territory infarction in VAH group（OR=4.397,95%CI：1.417-13.642,P=0.010;OR=11.996,95%CI：2.083-69.087,P=0.005）.The basilar artery convex to ipsilateral VAH was more than that to contralateral VAH（OR=4.076,95%CI：2.236-7.431,P=0.000）.Conclusion The incidence of posterior circulation proximal infarction is higher in ipsilateral VAH than in contralateral VAH.

关 键 词：椎动脉 脑梗死 椎底动脉供血不足 梗死 大脑后动脉 

分 类 号：R743.33[医药卫生—神经病学与精神病学]