椎-基底动脉结构变异与后循环脑梗死的关系  

Correlation between Structural Changes in Vertebral Basilar Artery System and Posterior Circulation Infarction

作　　者：宋元清 徐丽君[2] SONG Yuan-qing;XU Li-jun(Medical Department of Graduate School,Nanchang University,Nanchang 330006,China;Department of Neurology of the Second Affiliated Hospital,Nanchang University,Nanchang 330006,China;Department of Neurology,Jiujiang First People’s Hospital,Jiujiang 332000,China)

机构地区：[1]南昌大学研究生院医学部,南昌330006 [2]南昌大学第二附属医院神经内科,南昌330006 [3]九江市第一人民医院神经内科,江西九江332000

出　　处：《南昌大学学报（医学版）》2020年第4期37-40,45,共5页Journal of Nanchang University：Medical Sciences

基　　金：江西省卫健委普通科技计划(20187111)。

摘　　要：目的探讨椎-基底动脉结构变异与后循环脑梗死的关系。方法将513例脑梗死患者根据有无椎-基底动脉结构变异分为变异组(有变异)186例和对照组(无变异)327例,比较2组一般资料、后循环脑梗死发生率、后循环脑梗死不同区域[包括小脑上动脉区(SCA)、小脑后下动脉区(PICA)、大脑后动脉区(PCA)及基底动脉区(BA)]发生率。将变异组186例患者根据变异类型分为2个亚组:一侧椎动脉优势组(VAD组)84例和基底动脉迂曲延长组(VBD组)102例,比较2组后循环脑梗死、不同区域梗死发生率。结果变异组合并高同型半胱氨酸血症、高血压及脑缺血短暂发作病史发生率明显高于对照组(P<0.001)。变异组脑梗死类型以PICA区梗死、BA区梗死及SCA区梗死为主,分别为40.32%、27.42%、15.59%;对照组脑梗死类型以PCA区梗死及其他类型脑梗死为主,分别为27.83%、39.76%。变异组后循环脑梗死发生率、PICA区梗死发生率均明显高于对照组,PCA区梗死发生率明显低于对照组,差异均具有统计学意义(P<0.001)。VAD组与VBD组后循环脑梗死、不同区域梗死发生率比较差异均无统计学意义(P>0.05)。结论椎-基底动脉结构变异与高同型半胱氨酸血症、高血压病、脑缺血短暂发作病史及后循环脑梗死相关;椎-基底动脉结构变异增加了后循环脑梗死发病风险,其梗死类型以PICA区梗死为主。Objective To investigate the association between structural changes in vertebral basilar artery system and posterior circulation ischemic cerebral infarction(PoCI).Methods A total of 513 patients with cerebral infarction were divided into two groups:variation group(186 patients with structural changes in vertebral basilar artery system)and control group(327 patients without structural changes in vertebral basilar artery system).General data,total incidence of PoCI,and incidences of PoCI in regions of superior cerebellar artery(SCA),posterior inferior cerebellar artery(PICA),posterior cerebral artery(PCA)and basilar artery(BA)were compared between the two groups.In addition,patients in variation group were divided into two subgroups:vertebral artery dominance(VAD)group(84 patients)and vertebrobasilar dolichoectasia(VBD)group(102 patients).The total incidence of PoCI and incidences of PoCI in different regions were compared between the two subgroups.Results The incidences of hypertension,hyperhomocysteinemia and transient cerebral ischemic attack in variation group were higher than those in control group(P<0.001).In variation group,infarction mainly occurred in the regions of PICA(40.32%),BA(27.42%)and SCA(15.59%).In control group,infarction mainly occurred in PCA(27.83%)and other regions(39.76%).Compared with control group,the total incidence of PoCI and incidence of PICA infarction increased but the incidence of PCA infarction decreased in control group(P<0.001).There were no significant differences in the incidence of PoCI between VAD group and VBD group(P>0.05).Conclusion The structural changes in vertebral basilar artery system,hyperhomocysteinemia,hypertension and history of transient ischemic attack are closely related to PoCI.The structural changes in vertebral basilar artery system increase the risk of PoCI,and PICA infarction is the main type of PoCI.

关 键 词：椎-基底动脉结构变异 后循环脑梗死 小脑上动脉区 小脑后下动脉区 大脑后动脉区 基底动脉区 

分 类 号：R743[医药卫生—神经病学与精神病学]