CAJ | 학술논문

目的采用数字减影血管造影(DSA)探讨颅内外供血动脉中重度狭窄或闭塞的临床特点.方法回顾性分析408例动脉粥样硬化相关性缺血性脑血管病患者的DSA资料;分为脑梗死组和短暂性脑缺血发作(TIA)组.结果 408例患者中,247例(60.5%)存在脑供血动脉中重度狭窄或闭塞,共存在398处中重度狭窄或闭塞,主要累及颈内动脉起始段(23.4%)、大脑中动脉M1段(17.8%)、椎动脉V1段(16.8%);青年组和中年组单纯颅内动脉累及分别为5例(71.4%)和40例(54.8%),均显著高于老年组(49例,29.3%),差异有统计学意义(P＜0.05);单纯颅内动脉累及组的平均年龄[[(60.2±10.1)岁]显著低于单纯颅外动脉累及组[(66.9±8.9)岁]和颅内外动脉均累及组[(64.3±9.1)岁],差异有统计学意义(P＜0.05);颅内外动脉均累及组的胆固醇水平[(5.0±1.2) mmol/L]显著高于单纯颅外动脉累及组[(4.4±1.0 )mmol/L],差异有统计学意义(P＜0.05);单纯颅外动脉累及组合并嗜烟史者65例(59.1%),显著高于单纯颅内动脉累及组(37例,40.2%),差异有统计学意义(P＜0.01).结论颈内动脉起始段、大脑中动脉M1段、椎动脉V1段为脑供血动脉中重度狭窄或闭塞的好发部位;随着年龄的增长,颅外动脉受累所占比例明显增多;嗜烟史对颅外动脉影响更大.
목적 채용수자감영혈관조영(DSA)탐토로내외공혈동맥중중도협착혹폐새적림상특점.방법 회고성분석408례동맥죽양경화상관성결혈성뇌혈관병환자적DSA자료;분위뇌경사조화단잠성뇌결혈발작(TIA)조.결과 408례환자중,247례(60.5%)존재뇌공혈동맥중중도협착혹폐새,공존재398처중중도협착혹폐새,주요루급경내동맥기시단(23.4%)、대뇌중동맥M1단(17.8%)、추동맥V1단(16.8%);청년조화중년조단순로내동맥루급분별위5례(71.4%)화40례(54.8%),균현저고우노년조(49례,29.3%),차이유통계학의의(P＜0.05);단순로내동맥루급조적평균년령[[(60.2±10.1)세]현저저우단순로외동맥루급조[(66.9±8.9)세]화로내외동맥균루급조[(64.3±9.1)세],차이유통계학의의(P＜0.05);로내외동맥균루급조적담고순수평[(5.0±1.2) mmol/L]현저고우단순로외동맥루급조[(4.4±1.0 )mmol/L],차이유통계학의의(P＜0.05);단순로외동맥루급조합병기연사자65례(59.1%),현저고우단순로내동맥루급조(37례,40.2%),차이유통계학의의(P＜0.01).결론 경내동맥기시단、대뇌중동맥M1단、추동맥V1단위뇌공혈동맥중중도협착혹폐새적호발부위;수착년령적증장,로외동맥수루소점비례명현증다;기연사대로외동맥영향경대.
Objective To analyze the clinical characteristics of cerebral artery Moderate and severe stenosis or occlusion by Digital subtraction angiography(DSA).Methods The data of DSA of 408 patients with atherosclerosis-related ischemic cerebrovascular disease were analyzed Retrospectively,which were divided into cerebral infarction group and transient ischemic attack(TIA) group.Results 408 patients,247 cases(60.5%) had moderate and severe cerebral artery stenosis or occlusion,there is a total of 398 moderate and severe stenosis or occlusion,mainly involving initial segment of internal carotid artery(23.4%),M1 segment of middle cerebral artery(17.8%),V1 segment of vertebral artery(16.8%);Of youth group and middle-aged group,the cases involving intracranial artery only were five(71.4%) and 40(54.8%) respectively,significantly higher than the older group(49 cases,29.3%)(P＜0.01;P＜0.05);the average age of cases involving intracranial artery only was 60.2±10.1 years,significantly lower than that of cases involving extracranial artery only which was 66.9±8.9 years and that of cases involving intracranial artery and extracranial artery which was 64.3±9.1 years(P＜0.01;P＜0.05);the average TC level of cases involving intracranial artery and extracranial artery is 5.0±1.2mmol/L,significantly higher than that of cases involving extracranial artery only which was 4.4±1.0 mmol/L(P＜0.05);65 patients involving extracranial artery only had tobacco history(59.1%), significantly higher than that of cases involving intracranial artery only(37 cases,40.2%)(P＜0.01).Conclusion The predilection sites of moderate and severe cerebral artery stenosis or occlusion is internal carotid artery,M1 segment of middle cerebral artery and V1 segment of vertebral artery;with age increasing,the proportion of cases involving extracranial artery is increasing markedly;tobacco history has greater impact on the extracranial artery.