大脑后动脉伴发胚胎型改变与APCI及卒中严重程度关联的临床评估  

Clinical evaluation of the association between the posterior cerebral artery with embryonic changes and APCI and the severity of stroke

作　　者：暴丽华 冯志超 陈锦华 张丽芳 BAO Lihua;FENG Zhichao;CHEN Jinhua;ZHANG Lifang(Department of Neurology,Changzhi People's Hospital,Changzhi Shanxi 046000,China)

机构地区：[1]长治市人民医院神经内科,山西长治046000

出　　处：《中国急救复苏与灾害医学杂志》2023年第2期199-202,249,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：山西省基础研究项目(编号:2014021038)。

摘　　要：目的探讨大脑后动脉伴发胚胎型改变与急性后循环脑梗死(APCI)发生及卒中严重程度的关系。方法选取2019年10月—2020年10月长治市人民医院收治的229例经头颅MRI诊断为APCI的患者,根据磁共振血管造影术结果将患者分为胚胎型大脑后动脉(FTP)组126例和非FTP组103例。比较两组患者一般资料、梗死分布和后循环血管形态的关系。并采用美国国立卫生研究院卒中量表(NIHSS)将患者分为轻度卒中147组例和中重度卒中组82例,比较其临床资料,筛选影响因素,并采用Logistic回归分析大脑后动脉伴发胚胎型改变与卒中严重程度的关系。结果229例APCI患者中,FTP 126例,占比55.02%。FTP组患者近端梗死情况显著高于非FTP患者,且FTP组患者颅内段椎动脉狭窄和基底动脉弯曲凸向后循环血管异常情况显著高于非FTP患者,差异有统计学意义(P<0.05)。FTP组患者近端梗死情况显著高于非FTP患者,且FTP组患者颅内段椎动脉狭窄和基底动脉弯曲凸向后循环血管异常情况显著高于非FTP患者,差异有统计学意义(P<0.05)。中重度卒中组中糖尿病、完全型FTP(cFTP)、部分型FTP(pFTP)发生情况高于轻度卒中组,差异有统计学意义(P<0.05)。对有差异的因素进行Logictis回归分析,结果显示,cFTP、pFTP是APCI患者卒中严重程度的独立危险因素(OR>1,P<0.05)。结论大脑后动脉伴发胚胎型改变与APCI密切相关,脑梗死分布及形态是影响预后的重要因素,且大脑后动脉伴发胚胎型改变是卒中严重程度的独立危险因素,可根据其病变情况为临床脑梗死预后及卒中的发生和发展提供指导依据。Objective To investigate the relationship between the posterior cerebral artery with embryonal changes and the occurrence of acute posterior circulation infarction(APCI)and the severity of stroke.Methods Selected 229 patients with APCI diagnosed by cranial MRI in our hospital from October 2019 to October 2020.According to the results of magnetic resonance angiography(MRA),the patients were divided into fetal-type posterior cerebral artery(Fetal-type posterior cerebral artery,FTP)group with 126 cases and non-FTP group with 103 cases.The relationship between the general data,infarct distribution and posterior circulation vessel morphology was compared between the two groups.The National Institutes of Health Stroke Scale(NIHSS)was used to divide the patients into 147 cases of mild stroke and 82cases of moderate to severe stroke.The clinical data were compared,and the influencing factors were screened out.Logistic regression was used to analyze the complications of posterior cerebral artery.Association of embryonal alterations with stroke severity.Results Among the 229 APCI patients,126 were FTP,accounting for 55.02%.The incidence of proximal infarction in the FTP group was significantly higher than that in the non-FTP patients,and the intracranial vertebral artery stenosis and basilar artery curvature and posterior circulation abnormality in the FTP group were significantly higher than those in the non-FTP patients,and the differences were statistically significant(P<0.05).The incidence of proximal infarction in the FTP group was significantly higher than that in the non-FTP patients,and the intracranial vertebral artery stenosis and basilar artery curvature and posterior circulation abnormality in the FTP group were significantly higher than those in the non-FTP patients,and the differences were statistically significant(P<0.05).The incidences of diabetes,complete Fetal-type posterior cerebral artery(cFTP)and partial complete Fetal-type posterior cerebral artery(pFTP)in the moderate to severe stroke group were high

关 键 词：胚胎型大脑后动脉 后循环脑梗死 卒中程度 相关性 

分 类 号：R743[医药卫生—神经病学与精神病学]