中华神经科杂志
中華神經科雜誌
중화신경과잡지
Chinese Journal of Neurology
2012年
7期
490-494
,共5页
椎底动脉供血不足%椎动脉%先天畸形%脑梗死%基底动脉
椎底動脈供血不足%椎動脈%先天畸形%腦梗死%基底動脈
추저동맥공혈불족%추동맥%선천기형%뇌경사%기저동맥
Vertebrobasilar insufficiency%Vertebral artery%Congenital adnormalities%Brain infarction%Basilar artery
目的 探讨椎动脉优势(vertebral artery dominance)与后循环梗死发生率及梗死侧的关系.同时了解椎动脉优势与基底动脉弯曲的相关性.方法 134例缺血性脑血管疾病、脑出血及突发性耳聋患者根据其是否存在椎动脉优势分为有椎动脉优势68例(优势组)和无椎动脉优势66例(对照组).比较两组间后循环梗死总发生率,后循环各部位的梗死发生率以及基底动脉弯曲的发生率.统计优势组各梗死部位后循环梗死侧与椎动脉优势侧的相关性,基底动脉弯曲方向与椎动脉优势侧的相关性,基底动脉弯曲与否与后循环梗死的相关性.结果 优势组后循环梗死发生率高于对照组[45.6％ (31/68)与21.2％(14/66),x2=8.922,P=0.003].优势组小脑后下动脉(PICA)供血区梗死及基底动脉供血区梗死发生率显著高于对照组[11.8％ (8/68)与0,x2=8.250,P=0.004;20.6％(14/68)与7.6％ (5/66),x2=4.660,P =0.031]；两组的小脑上动脉供血区梗死率及大脑后动脉供血区梗死率差异无统计学意义.7例(7/8) PICA梗死患者梗死侧在椎动脉优势对侧.6例(6/14)基底动脉区梗死患者梗死侧与优势侧同侧.优势组基底动脉弯曲发生率显著高于对照组[50.0％(34/68)与9.1％ (6/66),x2=26.768,P=0.000].优势组基底动脉弯曲患者后循环梗死发生率与基底动脉呈直线的患者相仿,差异无统计学意义[ 52.9％ (18/34)与38.2％ (13/34),x2=1.482,P=0.223].优势组34例基底动脉弯曲的患者中,97.1％ (33/34)弯曲向椎动脉优势对侧.结论 椎动脉优势的患者较易发生后循环梗死,尤其是PICA和基底动脉供血区梗死,PICA供血区梗死部位一般在椎动脉优势对侧.椎动脉优势患者易致基底动脉弯曲,基底动脉一般弯向椎动脉优势对侧.
目的 探討椎動脈優勢(vertebral artery dominance)與後循環梗死髮生率及梗死側的關繫.同時瞭解椎動脈優勢與基底動脈彎麯的相關性.方法 134例缺血性腦血管疾病、腦齣血及突髮性耳聾患者根據其是否存在椎動脈優勢分為有椎動脈優勢68例(優勢組)和無椎動脈優勢66例(對照組).比較兩組間後循環梗死總髮生率,後循環各部位的梗死髮生率以及基底動脈彎麯的髮生率.統計優勢組各梗死部位後循環梗死側與椎動脈優勢側的相關性,基底動脈彎麯方嚮與椎動脈優勢側的相關性,基底動脈彎麯與否與後循環梗死的相關性.結果 優勢組後循環梗死髮生率高于對照組[45.6％ (31/68)與21.2％(14/66),x2=8.922,P=0.003].優勢組小腦後下動脈(PICA)供血區梗死及基底動脈供血區梗死髮生率顯著高于對照組[11.8％ (8/68)與0,x2=8.250,P=0.004;20.6％(14/68)與7.6％ (5/66),x2=4.660,P =0.031]；兩組的小腦上動脈供血區梗死率及大腦後動脈供血區梗死率差異無統計學意義.7例(7/8) PICA梗死患者梗死側在椎動脈優勢對側.6例(6/14)基底動脈區梗死患者梗死側與優勢側同側.優勢組基底動脈彎麯髮生率顯著高于對照組[50.0％(34/68)與9.1％ (6/66),x2=26.768,P=0.000].優勢組基底動脈彎麯患者後循環梗死髮生率與基底動脈呈直線的患者相倣,差異無統計學意義[ 52.9％ (18/34)與38.2％ (13/34),x2=1.482,P=0.223].優勢組34例基底動脈彎麯的患者中,97.1％ (33/34)彎麯嚮椎動脈優勢對側.結論 椎動脈優勢的患者較易髮生後循環梗死,尤其是PICA和基底動脈供血區梗死,PICA供血區梗死部位一般在椎動脈優勢對側.椎動脈優勢患者易緻基底動脈彎麯,基底動脈一般彎嚮椎動脈優勢對側.
목적 탐토추동맥우세(vertebral artery dominance)여후순배경사발생솔급경사측적관계.동시료해추동맥우세여기저동맥만곡적상관성.방법 134례결혈성뇌혈관질병、뇌출혈급돌발성이롱환자근거기시부존재추동맥우세분위유추동맥우세68례(우세조)화무추동맥우세66례(대조조).비교량조간후순배경사총발생솔,후순배각부위적경사발생솔이급기저동맥만곡적발생솔.통계우세조각경사부위후순배경사측여추동맥우세측적상관성,기저동맥만곡방향여추동맥우세측적상관성,기저동맥만곡여부여후순배경사적상관성.결과 우세조후순배경사발생솔고우대조조[45.6％ (31/68)여21.2％(14/66),x2=8.922,P=0.003].우세조소뇌후하동맥(PICA)공혈구경사급기저동맥공혈구경사발생솔현저고우대조조[11.8％ (8/68)여0,x2=8.250,P=0.004;20.6％(14/68)여7.6％ (5/66),x2=4.660,P =0.031]；량조적소뇌상동맥공혈구경사솔급대뇌후동맥공혈구경사솔차이무통계학의의.7례(7/8) PICA경사환자경사측재추동맥우세대측.6례(6/14)기저동맥구경사환자경사측여우세측동측.우세조기저동맥만곡발생솔현저고우대조조[50.0％(34/68)여9.1％ (6/66),x2=26.768,P=0.000].우세조기저동맥만곡환자후순배경사발생솔여기저동맥정직선적환자상방,차이무통계학의의[ 52.9％ (18/34)여38.2％ (13/34),x2=1.482,P=0.223].우세조34례기저동맥만곡적환자중,97.1％ (33/34)만곡향추동맥우세대측.결론 추동맥우세적환자교역발생후순배경사,우기시PICA화기저동맥공혈구경사,PICA공혈구경사부위일반재추동맥우세대측.추동맥우세환자역치기저동맥만곡,기저동맥일반만향추동맥우세대측.
Objective To investigate the correlation of vertebral artery dominance (VAD) with incidence and laterality of posterior circulation infarct,and observe the correlation of VAD and basal artery (BA) curvature.Methods Total incidence of posterior circulation infarcts,incidence of separate territory infarcts in posterior circulation and incidence of BA curvature were compared between 68 VAD patients and 66 controls.VA dominance,laterality of BA curvature and separate territory infarcts,and their directional relationships were observed in VAD group.Results The total incidence of posterior circulation infarcts in VAD group was significantly higher than that in controls(45.6％ (31/68) vs 21.2％ (14/66),x2 =8.922,P =0.003 ).The incidences of posterior inferior cerebellar artery (PICA) territory infarct and BA territory infarct were both significantly higher than that in controls ( 11.8％ ( 8/68 ) vs 0,x2 =8.250,P =0.004 ;20.6％ (14/68) vs 7.6％ (5/66),x2 =4.660,P =0.031 ).No differences were found in superior cerebellar artery (SCA) and posterior cerebral artery ( PCA ) territory infarcts between two groups.87.5 ％ (7/8) PICA infarcts were on the opposite side of dominant VA.42.9％ (6/14) BA infarcts were on the side of dominant VA.The incidence of BA curvature was significantly higher than that in controls(50.0％ (34/68) vs 9.1％ (6/66),x2 =26.768,P =0.000 ).No differences were found in the incidences of posterior circulation infarcts between BA curvature patients and BA straight patients(52.9％ (18/34) vs 38.2％ ( 13/34),x2 =1.482,P =0.223 ).97.1％ (33/34)patients had an opposite directional relationship between dominant VA and BA curvature in 37 BA curvature patients in VAD group.Conclusions The incidence of posterior circulation infarcts is higher in VAD patients,especially in PICA infarct and BA infarct patients.Most PICA infarcts occurred on the opposite side of dominant VA.The incidence of BA curvature is higher in VAD patients,and BA usually bends to the opposite side of dominant VA.
