脑血管变异与高血压的关联性  

The association between cerebral vascular variation and hypertension

作　　者：樊家成 惠颖 杨盈萍 赵艳生[4] 李梦宁 贾建新[1] 任炜 杨占君[1,5] FAN Jiacheng;HUI Ying;YANG Yingping;ZHAO Yansheng;LI Mengning;JIA Jianxin;REN Wei;YANG Zhanjun(Department of Human Anatomy,Baotou Medical College of Inner Mongolia University of Science and Technology,Inner Mongolia,Baotou,014040,China;Department of Radiology,Beijing Friendship Hospital,Capital Medical University;Department of Maternal and Child Health,School of Public Health,Tongji Medical College,Huazhong University of Science and Technology;MRI Room of Kailuan General Hospital;Department of Human Anatomy,Chifeng College,Inner Mongolia,Chifeng)

机构地区：[1]内蒙古科技大学包头医学院人体解剖学教研室,内蒙古包头014040 [2]首都医科大学附属北京友谊医院放射科 [3]华中科技大学同济医学院公共卫生学院儿少卫生与妇幼保健学教研室 [4]开滦总医院磁共振室 [5]赤峰学院人体解剖学教研室

出　　处：《中华高血压杂志（中英文）》2024年第3期236-242,共7页Chinese Journal of Hypertension

基　　金：国家自然科学基金(81860215);内蒙古自治区高等学校“青年科技英才支持计划”(NJYT-20-A08);内蒙古自治区高等学校创新团队发展计划(NMGIRT2328)。

摘　　要：目的探讨成人脑血管变异与高血压的关联性。方法采用横断面研究,以参加2020—2022年开滦总医院健康体检且进行磁共振检查的开滦集团在职和离退休职工作为观察对象,最终符合纳排标准的共1029人。将观察对象按无脑血管变异(217例,21.1%)、仅椎动脉发育不良(VAH)(118例,11.5%)、仅Wills后环发育不良(ipCoW)(482例,46.8%)以及联合变异(VAH+ipCoW)(212例,20.6%)分成4组。采用二元logistic回归模型分析不同脑血管变异类型对高血压的影响。结果观察对象年龄为(55.2±11.4)岁,无脑血管变异组、仅VAH组、仅ipCoW组以及联合变异组中高血压发生率分别为42.9%,49.2%,54.4%,70.8%(χ2=35.825,P<0.001)。以是否高血压为因变量,脑血管变异类型为自变量,在校正了多种混杂因素后,结果显示同时存在VAH和ipCoW两种脑血管变异与高血压具有正向关联(OR=2.410,95%CI 1.401~4.146)。分层分析显示,这种关联在年龄≤55岁的人群中更为明显(OR=4.437,95%CI 1.891~10.406),而在年龄>55岁的人群中没有发现相关性(P>0.05)。结论脑血管变异与高血压存在正向相关,并且这种关联主要存在于青年人群。Objective To investigate the association between cerebral vascular variation and hypertension in adults.Methods Using a cross-sectional study,the current and retired employees of Kailuan Group who participated in the physical examination of Kailuan General Hospital and underwent magnetic resonance imaging in 2020-2022were taken as the observation objects,and a total of 1,029participants were finally included.All partipants were divided into four groups:no cerebral vascular variation(217cases,21.1%),only vertebral artery hypoplasia(VAH)(118 cases,11.5%),only incomplete posterior Circle of Willis(ipCoW)(482cases,46.8%),and combined variations(VAH+ipCoW)(212cases,20.6%).Binary logistic regression models were conducted to explore the effects of different types of cerebral vascular variation on hypertension.Results The mean age of the study population was(55.2±11.4)years.The prevalence of hypertension were 42.9%,49.2%,54.4%,and 70.8%in the no cerebrovascular variant group,the VAH-only group,the ipCoW-only group,and the combined variant group,respectively(χ2=35.825,P<0.001).Hypertension was set as the dependent variable and cerebral vascular variation type was set as the independent variable,the results showed that the coexistence of VAH and ipCoW was positively associated with hypertension risk(OR=2.410,95%CI 1.401-4.146)after adjusting for multiple confounders.Stratified analysis showed that the association was more significant in the population aged 55years and younger(OR=4.437,95%CI 1.891-10.406),whereas no significant association was found in the population older than 55(P>0.05).Conclusion There is a positive association between cerebral vascular variation and hypertension,and this association is predominantly observed in the younger population.

关 键 词：脑血管变异 椎动脉发育不良 大脑动脉环 高血压 磁共振成像 年龄 开滦研究 

分 类 号：R743[医药卫生—神经病学与精神病学] R544.1[医药卫生—临床医学]