椎动脉形态学异常对后循环短暂性脑缺血发作症状持续时间的影响  

Effect of Vertebral Artery Morphological Anomaly on the Duration of Symptoms in Patients with Posterior Circulation Transient Ischemic Attack

作　　者：金戈 王军伟 陈亮 杨涌涛 郑方硕 张余 展群岭 JIN Ge;WANG Jun-Wei;CHEN Liang;YANG Yong-Tao;ZHENG Fang-Shuo;ZHANG Yu;ZHAN Qun-Ling(Department of Neurology,Chongqing Renji Hospital,University of Chinese Academy of Sciences(Fifth People's Hospital of Chongqing),Chongqing 400062,China;Department of Interventional Radiology,Chongqing Renji Hospital,University of Chinese Academy of Sciences(Fifth People's Hospital of Chongqing),Chongqing 400062,China)

机构地区：[1]中国科学院大学重庆仁济医院(重庆市第五人民医院)神经内科,重庆400062 [2]中国科学院大学重庆仁济医院(重庆市第五人民医院)放射介入科

出　　处：《中国卒中杂志》2020年第11期1198-1203,共6页Chinese Journal of Stroke

基　　金：重庆市南岸区科技计划项目(南岸科委发2016-20号);重庆市卫计委医学科研计划项目(2015MSXM113)。

摘　　要：目的探讨椎动脉形态学异常对后循环TIA症状持续时间的影响。方法回顾性分析2015年10月-2018年3月在中国科学院大学重庆仁济医院神经内科完成头颈部DSA或CTA的后循环TIA住院患者临床资料,根据症状持续时间分为<10 min组、10~59 min组和≥60 mi n组,比较椎动脉形态异常各亚型在3组间的差异。通过多因素Logistic回归分析明确椎动脉形态异常与后循环TIA症状持续时间之间的关系。结果共纳入237例患者,其中症状持续时间<10 min组109例(45.99%)、10~59 min组71例(29.96%)和≥60 min组57例(24.05%)。一般临床资料的比较显示,性别、椎动脉和基底动脉狭窄率≥50%在3组间差异具有统计学意义(P<0.05)。椎动脉形态异常中,动脉粥样硬化性椎动脉狭窄(狭窄率1%~99%)在3组间的差异具有统计学意义(P=0.004),而一侧迂曲、双侧迂曲、一侧优势、一侧优势合并迂曲和起源异常在3组间差异均无统计学意义;多因素Logi sti c回归分析显示椎动脉狭窄(OR 2.500,95%CI 1.381~4.525,P=0.002)、基底动脉狭窄率≥50%(OR 12.066,95%CI 1.446~100.668,P=0.021)是TI A症状持续时间延长的独立影响因素。结论椎动脉狭窄和基底动脉狭窄率≥50%是影响后循环TIA症状持续时间延长的独立影响因素。Objective To investigate the effect of vertebral artery(VA)morphological anomaly on the duration of symptoms in patients with posterior circulation TIA.Methods The data of patients with posterior circulation TIA who underwent head and neck DSA or CTA from Chongqing Renji Hospital,University of Chinese Academy of Sciences between October 2015 to March 2018 were retrospectively analyzed.According to the duration of symptoms,patients were divided into three groups:duration of symptoms<10 minutes,10-59 minutes and ≥60 minutes.The differences of subtypes of VA morphological anomaly were compared among the three groups.The association between morphological anomaly of VA and the duration of symptoms of TIA was determined by multivariable logistic regression analysis.Results A total of 237 patients were included,there were 109(45.99%),71(29.96%),and 57(24.05%)patients in the group of duration of symptoms<10 minutes,10-59 minutes and ≥60 minutes,respectively.There were statistical differences in sex and the rate of stenosis ≥50% in VA and basilar artery(P<0.05)among the three groups.For VA morphological anomaly,VA atherosclerotic stenosis among the three groups had statistical difference(P=0.004);while there were no statistical differences in unilateral VA tortuosity,bilateral VA tortuosity,unilateral dominance,unilateral dominance plus tortuosity and origin abnormality among the three groups(all P>0.05).The multivariate logistic regression analysis showed that VA stenosis(OR 2.500,95%CI 1.381-4.525,P=0.002)and basilar artery stenosis ≥50%(OR 12.066,95%CI 1.446-100.668,P=0.021)were independent influencing factors for the duration of symptoms of posterior circulation TIA.Conclusions VA stenosis and basilar artery stenosis ≥50% are independent risk factors for the duration of symptoms in posterior circulation TIA.

关 键 词：椎动脉 形态学异常 短暂性脑缺血发作 卒中风险 

分 类 号：R743.31[医药卫生—神经病学与精神病学]