单侧VA重度狭窄或闭塞部位与后循环缺血症状的相关性分析  

Correlation between Severe Stenosis or Occlusion of Unilateral VA and Symptoms of Posterior Circulation Ischemia

作　　者：陈利 雷波[1] 吴嘉川 郑念东[1] CHEN Li;LEI Bo;WU Jia-chuan(Department of Cerebrovascular Diseases,Leshan People's Hospital,Leshan Sichuan 614100)

机构地区：[1]乐山市人民医院脑血管病科,四川乐山614100

出　　处：《医学临床研究》2023年第2期191-194,共4页Journal of Clinical Research

基　　金：乐山市科技局课题(18SZD154)。

摘　　要：【目的】探讨单侧椎动脉(VA)重度狭窄或闭塞部位与后循环缺血症状的相关性。【方法】回顾性分析本院收治的177例单侧VA重度狭窄或闭塞患者的临床资料,所有患者入院后均接受磁共振(MRI)、数字减影血管造影(DSA)、颈部动脉超声(CDU)检查,评估患者VA重度狭窄或闭塞部位、VA重度狭窄及闭塞情况、单侧VA重度狭窄或闭塞患者是否伴有后循环缺血症状、血流动力学参数[收缩期峰值血流速(PSV)、舒张末期血流速(EDV)、血管阻力指数(RI)、椎动脉管径(VAD)]。比较起始段、颅外段、颅内段单侧VA重度狭窄或闭塞患者血流动力学参数差异,观察不同VA重度狭窄或闭部位患者后循环缺血症状发生情况。【结果】177例患者均完成MRI及DSA检查,DSA检查中VA重度狭窄62.71%、轻度狭窄37.29%;MRI检查中VA起始段重度狭窄或闭塞54.24%、颅外段重度狭窄或闭塞16.95%、颅内段重度狭窄或闭塞28.81%,起始段重度狭窄或闭塞中重度狭窄83.33%、闭塞16.67%,颅外段重度狭窄或闭塞中重度狭窄46.67%、闭塞53.33%,颅内段重度狭窄或闭塞中重度狭窄33.33%、闭塞66.67%。MRI检查中48.02%(85/177)存在后循环缺血症状,51.98%(92/177)无后循环缺血症状。起始段VA重度狭窄或闭塞患者患侧PSV、EDV、RI、VAD低于健侧(P<0.05)。颅外段VA重度狭窄或闭塞患者患侧PSV、EDV高于健侧,患侧VAD低于健侧,差异均有统计学意义(均P<0.05);颅外段VA重度狭窄或闭塞患者患侧及健侧RI比较,差异无统计学意义(P>0.05)。颅内段VA重度狭窄或闭塞患者患侧PSV、EDV、VAD低于健侧,RI高于健侧(P<0.05)。颅外段、颅内段VA重度狭窄或闭塞患者后循环缺血症状(短暂性脑缺血、脑梗死)发生率高于起始段,差异有统计学意义(P<0.05)。【结论】后循环缺血症状的发生与VA重度狭窄或闭塞部位存在一定关系,单侧VA重度狭窄或闭塞患者治疗前及时行影像学检查能够为疾�【Objective】To explore the correlation between the severe stenosis or occlusion of unilateral vertebral artery(VA)and the symptoms of posterior circulation ischemia.【Methods】The clinical data of 177 patients with unilateral VA severe stenosis or occlusion admitted to our hospital were analyzed retrospectively.All patients underwent magnetic resonance imaging(MRI),digital subtraction angiography(DSA)and carotid artery ultrasound(CDU)after admission;The site of VA severe stenosis or occlusion,the condition of VA severe stenosis and occlusion,whether the patients with unilateral VA severe stenosis or occlusion had symptoms of posterior circulation ischemia,and hemodynamic parameters[peak systolic blood flow velocity(PSV),end-diastolic blood flow velocity(EDV),vascular resistance index(RI),and vertebral artery diameter(VAD)]were evaluated.The differences of hemodynamic parameters in patients with unilateral VA severe stenosis or occlusion in the initial segment,extracranial segment and intracranial segment were compared,and the occurrence of posterior circulation ischemia symptoms in patients with different VA severe stenosis or occlusion was observed.【Results】All 177 patients completed MRI and DSA examination.The DSA examination showed that 62.71%of VA severe stenosis and 37.29%of VA mild stenosis;In MRI examination,54.24%of VA initial segment severe stenosis or occlusion,16.95%of extracranial segment severe stenosis or occlusion,28.81%of intracranial segment severe stenosis or occlusion,83.33%of initial segment severe stenosis or occlusion moderate and severe stenosis,16.67%of occlusion,46.67%of extracranial segment severe stenosis or occlusion moderate and severe stenosis,53.33%of occlusion,33.33%of intracranial segment severe stenosis or occlusion moderate and severe stenosis,66.67%of occlusion.In MRI examination,48.02%(85/177)had symptoms of posterior circulation ischemia,and 51.98%(92/177)had no symptoms of posterior circulation ischemia.PSV,EDV,RI and VAD of the affected side of patients with severe

关 键 词：脑缺血发作 短暂性 椎底动脉供血不足 数据相关性 

分 类 号：R743.33[医药卫生—神经病学与精神病学]