国际脑血管病杂志
國際腦血管病雜誌
국제뇌혈관병잡지
INTERNATIONAL JOURNAL OF CEREBROVASCULAR DISEASES
2012年
9期
672-677
,共6页
卒中%脑缺血%基底动脉%椎动脉%磁共振血管造影%危险因素
卒中%腦缺血%基底動脈%椎動脈%磁共振血管造影%危險因素
졸중%뇌결혈%기저동맥%추동맥%자공진혈관조영%위험인소
Stroke%Brain Ischemia%Basilar Artery%Vertebral Artery%Vertebrobasilar Insufficiency%Magnetic Resonance Angiography%Risk Factors
目的 比较缺血性卒中患者椎基底动脉扩张延长症(vertebrobasilar dolichoectasia,VBD)的临床和影像学特征,探讨缺血性卒中患者VBD以及伴有VBD患者后循环梗死的危险因素.方法 急性缺血性卒中患者根据磁共振血管造影(magnetic resonance angiography,MRA)结果分为VBD组和非VBD组,根据牛津郡社区卒中项目分型标准分为前循环梗死和后循环梗死.回顾性收集人口统计学、血管危险因素、影像学和其他临床资料并进行比较,采用多变量logistic回归分析确定VBD以及VBD患者后循环梗死的独立危险因素.结果 共纳入269例急性脑梗死患者,28例(10.41％)存在VBD.VBD组年龄[(70.38±10.58)岁对(62.86±12.20)岁；t=2.870,P=0.009]、男性(78.6％对66.8％；x2=4.392,P=0.036)和高血压患者比例(89.3％对47.7％；x2=17.367,P=0.000)显著高于非VBD组；两组脑梗死亚型也存在显著差异(x2=10.776,P=0.015),VBD组以后循环梗死多见(57.1％),非VBD以部分前循环梗死多见(43.6％).多变量logistic回归分析显示,高龄[优势比(odds ratio,OR)1.248,95％可信区间(confidence interval,CI) 1.137～1.371；P=0.000]、高血糖(OR 1.599,95％ CI 1.181 ～2.164;P=0.002)、高血压(OR 1.251,95％ CI 1.020～1.534,P=0.032)和三酰甘油水平增高(OR 1.876,95％ CI 1.021 ～3.445,P=0.043)是VBD的独立危险因素,而女性(OR 0.133,95％ CI 0.024 ～0.735;P =0.021)为VBD的独立保护因素.在28例伴有VBD的脑梗死患者中,前循环梗死9例,后循环梗死19例.前循环梗死组基底动脉直径[(5.40±0.49)cm对(6.00 ±0.77) cm;t=2.046,P=0.041]显著小于后循环梗死组,而基底动脉分叉高度评分(x2=6.768,P=0.037)和基底动脉侧移(x2=5.241,P=0.042)评分较高者的构成比显著低于后循环梗死组；多变量logistic回归分析显示,基底动脉分叉高为VBD患者后循环梗死的独立危险因素(OR 1.347,95％ CI 1.069 ～2.457;P=0.038).结论 高龄、高血糖、高血压和三酰甘油水平增高为VBD的独立危险因素,女性为VBD的独立保护因素.而基底动脉分叉高为VBD患者后循环梗死的独立危险因素.
目的 比較缺血性卒中患者椎基底動脈擴張延長癥(vertebrobasilar dolichoectasia,VBD)的臨床和影像學特徵,探討缺血性卒中患者VBD以及伴有VBD患者後循環梗死的危險因素.方法 急性缺血性卒中患者根據磁共振血管造影(magnetic resonance angiography,MRA)結果分為VBD組和非VBD組,根據牛津郡社區卒中項目分型標準分為前循環梗死和後循環梗死.迴顧性收集人口統計學、血管危險因素、影像學和其他臨床資料併進行比較,採用多變量logistic迴歸分析確定VBD以及VBD患者後循環梗死的獨立危險因素.結果 共納入269例急性腦梗死患者,28例(10.41％)存在VBD.VBD組年齡[(70.38±10.58)歲對(62.86±12.20)歲；t=2.870,P=0.009]、男性(78.6％對66.8％；x2=4.392,P=0.036)和高血壓患者比例(89.3％對47.7％；x2=17.367,P=0.000)顯著高于非VBD組；兩組腦梗死亞型也存在顯著差異(x2=10.776,P=0.015),VBD組以後循環梗死多見(57.1％),非VBD以部分前循環梗死多見(43.6％).多變量logistic迴歸分析顯示,高齡[優勢比(odds ratio,OR)1.248,95％可信區間(confidence interval,CI) 1.137～1.371；P=0.000]、高血糖(OR 1.599,95％ CI 1.181 ～2.164;P=0.002)、高血壓(OR 1.251,95％ CI 1.020～1.534,P=0.032)和三酰甘油水平增高(OR 1.876,95％ CI 1.021 ～3.445,P=0.043)是VBD的獨立危險因素,而女性(OR 0.133,95％ CI 0.024 ～0.735;P =0.021)為VBD的獨立保護因素.在28例伴有VBD的腦梗死患者中,前循環梗死9例,後循環梗死19例.前循環梗死組基底動脈直徑[(5.40±0.49)cm對(6.00 ±0.77) cm;t=2.046,P=0.041]顯著小于後循環梗死組,而基底動脈分扠高度評分(x2=6.768,P=0.037)和基底動脈側移(x2=5.241,P=0.042)評分較高者的構成比顯著低于後循環梗死組；多變量logistic迴歸分析顯示,基底動脈分扠高為VBD患者後循環梗死的獨立危險因素(OR 1.347,95％ CI 1.069 ～2.457;P=0.038).結論 高齡、高血糖、高血壓和三酰甘油水平增高為VBD的獨立危險因素,女性為VBD的獨立保護因素.而基底動脈分扠高為VBD患者後循環梗死的獨立危險因素.
목적 비교결혈성졸중환자추기저동맥확장연장증(vertebrobasilar dolichoectasia,VBD)적림상화영상학특정,탐토결혈성졸중환자VBD이급반유VBD환자후순배경사적위험인소.방법 급성결혈성졸중환자근거자공진혈관조영(magnetic resonance angiography,MRA)결과분위VBD조화비VBD조,근거우진군사구졸중항목분형표준분위전순배경사화후순배경사.회고성수집인구통계학、혈관위험인소、영상학화기타림상자료병진행비교,채용다변량logistic회귀분석학정VBD이급VBD환자후순배경사적독립위험인소.결과 공납입269례급성뇌경사환자,28례(10.41％)존재VBD.VBD조년령[(70.38±10.58)세대(62.86±12.20)세；t=2.870,P=0.009]、남성(78.6％대66.8％；x2=4.392,P=0.036)화고혈압환자비례(89.3％대47.7％；x2=17.367,P=0.000)현저고우비VBD조；량조뇌경사아형야존재현저차이(x2=10.776,P=0.015),VBD조이후순배경사다견(57.1％),비VBD이부분전순배경사다견(43.6％).다변량logistic회귀분석현시,고령[우세비(odds ratio,OR)1.248,95％가신구간(confidence interval,CI) 1.137～1.371；P=0.000]、고혈당(OR 1.599,95％ CI 1.181 ～2.164;P=0.002)、고혈압(OR 1.251,95％ CI 1.020～1.534,P=0.032)화삼선감유수평증고(OR 1.876,95％ CI 1.021 ～3.445,P=0.043)시VBD적독립위험인소,이녀성(OR 0.133,95％ CI 0.024 ～0.735;P =0.021)위VBD적독립보호인소.재28례반유VBD적뇌경사환자중,전순배경사9례,후순배경사19례.전순배경사조기저동맥직경[(5.40±0.49)cm대(6.00 ±0.77) cm;t=2.046,P=0.041]현저소우후순배경사조,이기저동맥분차고도평분(x2=6.768,P=0.037)화기저동맥측이(x2=5.241,P=0.042)평분교고자적구성비현저저우후순배경사조；다변량logistic회귀분석현시,기저동맥분차고위VBD환자후순배경사적독립위험인소(OR 1.347,95％ CI 1.069 ～2.457;P=0.038).결론 고령、고혈당、고혈압화삼선감유수평증고위VBD적독립위험인소,녀성위VBD적독립보호인소.이기저동맥분차고위VBD환자후순배경사적독립위험인소.
Objective To investigate the clinical and imaging features in patients with vertebrobasilar dolichoectasia (VBD) through a comparative study in patients with ischemic stroke with or without VBD.Methods The patients with acute cerebral infarction were divided into either a VBD group or a non-VBD group according to magnetic resonance angiography.The VBD group was further divided into an anterior circulation infarction subgroup and a posterior circulation infarction subgroup.The cardiovascular risk factors,the diameter of basiar artery (BA),bifurcation height,and horizontal displacement were compared in all groups.Results A total of 269 patients with acute cerebral infarction were included,28 had VBD,accounting for 10.41％ of the patients with acute cerebral infarction during the same period.The proportion of male patients (78.6％ vs.66.8％ ;x2 =4.392,P =0.036),age (70.38 ± 10.58 years vs.62.86 ± 12.20 years; t =2.870,P =0.009),and the proportion of hypertension (89.3％ vs.47.7％ ; x2 =17.367,P =0.000) in the VBD group were significantly higher than those in the non-VBD group.The multivariate logistic regression analysis showed that the advanced age (odds ratio [OR] 1.248,95％ confidence interval [CI] 1.137-1.371; P=0.000),hyperglycemia (OR 1.599,95％ CI 1.181-2.164; P =0.002),hypertension (OR 1.251,95％ CI 1.020-1.534; P =0.032) and increased triglyceride level (OR 1.876,95％ CT 1.021-3.445; P =0.043) were the independent risk factors for VBD,while female gender (OR 0.133,95％ CI 0.024-0.735; P =0.021) was the independent protective factor for VBD.Of the 28 cerebral infarction patients with VBD,9 had anterior circulation infarction and 19 had posterior circulation infarction.There were significant differences in BA diameter ([5.40 ± 0.49] cm vs.[6.00 ± 0.77] cm; t =2.046,P =0.041),and the proportions of high score in bifurcation height (x2 =6.768,P =0.037) and horizontal displacement (x2 =5.241,P =0.042) between the 2 groups (all P ＜0.05).The multivafiate logistic regression analysis showed that the BA bifurcation height was an independent risk factor for posterior circulation infarction (OR 1.347,95％ CI 1.069-2.457; P =0.038) in patients with VBD.Conclusions VBD accounted for 10.41％ of the patients with acute cerebral infarction during the same period.Advanced age,hyperglycemia,hypertension and increased triglyceride level were the independent risk factors for VBD.Female gender was the independent protective factors for VBD,and the BA bifurcation height was an independent risk factor for VBD occurring posterior circulation infarction.
