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目的探讨后循环脑梗死患者血管病变的特点。方法收集2012年1月~2013年7月在中国中医科学院西苑医院神经内科住院的缺血性脑血管病患者245例。通过螺旋CT血管造影(CTA)对比87例后循环脑梗死患者及158例后循环无脑梗死患者的后循环动脉病变差异,分析后循环脑梗死患者血管病变部位、狭窄程度及形态特点。结果在后循环脑梗死患者中,椎动脉中、重度狭窄及闭塞的血管数多于基底动脉和大脑后动脉,差异有高度统计学意义(P<0.01)。在椎动脉硬化狭窄病变中,起始段及颅内段占82.18%。后循环脑梗死患者中、重度狭窄及闭塞的动脉数明显多于后循环无脑梗死患者,差异有高度统计学意义(P<0.01)。后循环梗死患者椎动脉发育不良率明显高于后循环无脑梗死患者,差异有高度统计学意义(P<0.01)。结论后循环脑梗死患者主要血管病变为动脉粥样硬化狭窄,以椎动脉起始段及颅内段最常见。椎动脉发育不良是后循环脑梗死的危险因素。
Objective To investigate the characteristics of vascular lesions in patients with posterior circulation cerebral infarction. Methods A total of 245 patients with ischemic cerebrovascular disease were admitted to Department of Neurology, Xiyuan Hospital of Chinese Academy of Traditional Chinese Medicine from January 2012 to July 2013. Spiral CT angiography (CTA) was used to compare the posterior circulation arterial lesions in 87 patients with posterior circulation cerebral infarction and 158 patients with posterior circulation cerebral infarction, and to analyze the vascular lesion, stenosis and morphological features in patients with posterior circulation cerebral infarction. Results In patients with posterior circulation cerebral infarction, there were more blood vessels in the vertebral artery than those in the basilar and posterior cerebral arteries. The difference was statistically significant (P <0.01). Vertebral artery stenosis lesions, the initial and intracranial segments accounted for 82.18%. In patients with posterior circulation cerebral infarction, the number of severe stenosis and occlusion of arteries was significantly more than that of posterior circulation without cerebral infarction, the difference was highly statistically significant (P <0.01). The rate of dysplasia of vertebral artery in patients with posterior circulation infarction was significantly higher than that in patients with posterior circulation without cerebral infarction, the difference was highly statistically significant (P <0.01). Conclusions The main vascular lesion in patients with posterior circulation cerebral infarction is atherosclerosis stenosis. The initial and intracranial segments of vertebral artery are the most common. Vertebral artery dysplasia is a risk factor for posterior circulation cerebral infarction.