颅内段与颅外段后循环动脉夹层的危险因素临床特点及影像特征分析  

Comparison of predisposing factors,clinical presentations,and radiological features in patients with intracranial and extracranial posterior circulation artery dissection

作　　者：吴永钧 陈红兵[1] 陈歆然[1] 谭双全[1] 邢世会[1] 谭燕 张健[1] WU Yongjun;CHEN Hongbin;CHEN Xinran(Department of Neurology,The First Affiliated Hospital,Sun Yat-sen University,Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases,National Key Clinical Department and Key Discipline of Neurology,Guangzhou 510080,China)

机构地区：[1]中山大学附属第一医院神经科,广东省重大神经疾病诊治研究重点实验室,国家临床重点专科和国家重点学科,广东广州510080 [2]广西中医药大学第一附属医院神经科,广西南宁530012

出　　处：《中风与神经疾病杂志》2021年第11期1001-1006,共6页Journal of Apoplexy and Nervous Diseases

基　　金：国家重点研发计划项目(2017YFC1307500);广东省自然科学基金资助项目(2017A030313575);华南神经疾病早期干预及功能修复研究国际合作基地资助项目(2015B050501003);广东省神经系统重大疾病诊治工程技术研究中心、广东省神经系统重大疾病诊治转化医学创新平台、广东省神经系统疾病临床医学研究中心资助项目。

摘　　要：目的头颈动脉夹层是青壮年卒中的主要病因。目前关于后循环头颈动脉夹层的研究很少。我们比较了颅内段与颅外段后循环动脉夹层的易感因素、临床特点及影像特征。方法选取近十年确诊后循环头颈动脉夹层患者,依据夹层病变部位不同分为颅内段组与颅外段组,比较两组患者的基线资料、易感因素、临床表现、影像特征差异。结果共59例患者纳入研究,分为颅内段后循环动脉夹层组33例、颅外段组26例。颅外段组年龄比颅内组更年轻(P=0.0022)。平均年龄分别为(45.12±13.33)岁与(34.85±10.57)岁。颅内组17例(51.52%)合并有吸烟史,颅外组3例(15.54%),差异有统计学意义(P=0.0013)。颅外段组发病前有外伤诱因的患者更常见(26.92%VS 6.06%,P=0.0269)。颅内组患者头痛更多,而颅外组患者颈部疼痛更多。结论颅内、颅外后循环动脉夹层的易感因素及临床表现有所不同,有助于后循环颅内、颅外动脉夹层的鉴别。Objective Cervicocerebral artery dissection(CAD)is an important cause of ischemic stroke in young and middle-aged individuals.At present,there are few studies on posterior circulation CAD.We compared the predisposing factors,clinical presentations,and radiological features in patients with intracranial and extracranial posterior circulation CAD.Methods Patients diagnosed with posterior circulation CAD in the last decade were enrolled.All patients were divided into the extracranial or intracranial group according to the lesion location of the dissection.The data of baseline characteristics,predisposing factors,clinical manifestations,and radiological features of the two groups were compared.Results A total of 59 patients were included in the study,including 33 patients in the intracranial posterior circulation CAD group and 26 patients in the extracranial group.The age of the extracranial group was younger than that of the intracranial group(P=0.0022).The mean age was(45.12±13.33)and(34.85±10.57)years old,respectively.Smoking was more often in the intracranial group(51.52%)than extracranial group(15.54%,P=0.0013).Additionally,a history of head or neck trauma was more frequently observed in the extracranial group compared with the intracranial group(26.92%vs.6.06%,P=0.0269).Headache was more common in the intracranial group.By contrast,neck pain was more frequently in the extracranial group.Conclusions The predisposing factors and clinical presentations of intracranial and extracranial CAD were different.These differences may help to distinguish intracranial and extracranial posterior circulation dissection.

关 键 词：动脉夹层 脑梗死 后循环 影像特征 易感因素 

分 类 号：R743[医药卫生—神经病学与精神病学]