CAJ | 학술논문

目的：探讨兰州地区缺血性脑血管病患者脑动脉狭窄的程度及范围特点。方法对261例行数字剪影血管造影术（DSA ）的缺血性脑血管病患者造影资料进行回顾性分析。根据年龄将患者分为青年组（6～44岁）、中年组（45～59岁）和老年组（≥60岁）。根据北美症状性颈动脉内膜切除研究法计算狭窄率。结果261例患者中发现脑动脉狭窄或闭塞占70.11％，造影正常占29.89％，其中单纯颅内狭窄为40.98％，单纯颅外为32.79％，颅内外并存26.23％。（1）青年组单纯颅内狭窄者比例71.43％，显著高于中年组33.93％（ P＜0.01）及老年组26.92％（ P＜0.01）；老年组颅内外血管狭窄并存者比例37.18％，高于青年组16.33％（ P＜0.05）及中年组19.64％（ P＜0.05）。（2）183例患者狭窄部位237处、闭塞88处，共325处；青年组患者闭塞比例为39.77％，显著高于中年组19.63％（ P＜0.01）及老年组22.38％（ P＜0.01）。（3）脑梗死患者117例，位于颅内占36.75％，颅外占35.90％，颅内外占27.35％；短暂性脑缺血发作（T IA ）患者66例，位于颅内占48.49％，颅外占27.27％，颅内外共存的24.24％；2组血管狭窄的分布无明显差异（ P＞0.05）。（4）脑梗死组血管狭窄220处，轻中度狭窄占44.09％，重度狭窄占26.36％，闭塞占29.55％；T IA组血管狭窄105处，轻中度狭窄占66.67％，重度狭窄占11.43％，闭塞23处占21.90％；脑梗死组脑供血动脉狭窄程度较TIA组严重（P＜0.01）。结论 ICVD患者不同年龄段狭窄部位分布有差异，青年组闭塞部位较中年组及老年组多。脑梗死和 T IA患者狭窄分布无明显差异，脑梗死组血管狭窄的严重程度与 T IA组有明显差异。
목적：탐토란주지구결혈성뇌혈관병환자뇌동맥협착적정도급범위특점。방법대261례행수자전영혈관조영술（DSA ）적결혈성뇌혈관병환자조영자료진행회고성분석。근거년령장환자분위청년조（6～44세）、중년조（45～59세）화노년조（≥60세）。근거북미증상성경동맥내막절제연구법계산협착솔。결과261례환자중발현뇌동맥협착혹폐새점70.11％，조영정상점29.89％，기중단순로내협착위40.98％，단순로외위32.79％，로내외병존26.23％。（1）청년조단순로내협착자비례71.43％，현저고우중년조33.93％（ P＜0.01）급노년조26.92％（ P＜0.01）；노년조로내외혈관협착병존자비례37.18％，고우청년조16.33％（ P＜0.05）급중년조19.64％（ P＜0.05）。（2）183례환자협착부위237처、폐새88처，공325처；청년조환자폐새비례위39.77％，현저고우중년조19.63％（ P＜0.01）급노년조22.38％（ P＜0.01）。（3）뇌경사환자117례，위우로내점36.75％，로외점35.90％，로내외점27.35％；단잠성뇌결혈발작（T IA ）환자66례，위우로내점48.49％，로외점27.27％，로내외공존적24.24％；2조혈관협착적분포무명현차이（ P＞0.05）。（4）뇌경사조혈관협착220처，경중도협착점44.09％，중도협착점26.36％，폐새점29.55％；T IA조혈관협착105처，경중도협착점66.67％，중도협착점11.43％，폐새23처점21.90％；뇌경사조뇌공혈동맥협착정도교TIA조엄중（P＜0.01）。결론 ICVD환자불동년령단협착부위분포유차이，청년조폐새부위교중년조급노년조다。뇌경사화 T IA환자협착분포무명현차이，뇌경사조혈관협착적엄중정도여 T IA조유명현차이。
Objective To investigate the distribution characteristics and severity of cerebral artery stenosis in patients with ischemic cerebrovascular disease (ICVD).Methods The data of cerebral angiography in 261 patients with ischemic cerebrovas-cular disease who performed cerebral angiography were analyzed retrospectively.They were divided into young (aged 6-44 years) ,middle-aged (aged 45-59 years) ,and elderly (aged≥60 years) groups according to their ages.Results 70.11% pa-tients had cerebral artery stenosis or occlusion ,and 29.89% patients had no cerebral artery stenosis.Intracranial artery stenosis was 40.98% ,extracranial artery stenosis was 32.79% ,and extra-and intracranial artery stenosis was 26.23%.(1)The propor-tion of intracranial artery stenosis in the young group (71.43% ) was significantly higher than that in the middle-aged group (33.93% ,P<0.01) and that in the elderly group (26.92% ,P<0.01).The proportion of extra-and intracranial artery stenosis in the elderly group (37.18% ) was significantly higher than that in the young group (16.33% ,P<0.05) and that in the mid-dle-aged group (19.64% ,P< 0.05).(2)In the 261 cases ,325 lesions were found ,including 237 stenoses and 88 occlu-sions.The proportion of occlusions in the young group (39.77% ) was significantly higher than that in the middle-aged group (19.63% ,P<0.01) and that in the elderly group (22.38% ,P<0.01).(3)The patients with cerebral infarction were 117 ,and the proportion of intracranial artery stenosis was 36.75% ,while extracranial artery stenosis was 35.90% ,and the extra-and intracranial artery stenosis was 27.35%.The patients with transient ischemic attack (TIA) were 66 ,and the proportion of in-tracranial artery stenosis was 48.49% ,while extracranial artery stenosis was 27.27% ,and the extra-and Intracranial artery stenosis was 24.24% ;there are no significant difference between two groups in the distribution of vascular stenosis (P>0.05) . (4)In cerebral infarction group 220 lesions were found ,and the proportion of mild-moderate stenosis was 44.09% ,while se-vere stenosis was 26.36% ,and the occlusions was 29.55%.In TIA group 105 lesions were found ,and the proportion of mild-moderate stenosis was 66.67% ,while severe stenosis was 11.43% ,and the occlusions was 21.90%.The difference of sevetity of artery stenosis between TIA group and cerebral infarction group was distinct (P<0.01).Conclusion There are differences between the stenosis distribution in ICVD patients with different ages.The occlusions in young group are more than middle-aged and elderly group.No obvious difference is found between cerebral infarction and TIA patients with stenosis distribution ,the severity of the stenosis of cerebral infarction group and the TIA group have obvious difference.