CAJ | 학술논문

目的：探讨狭窄≥50%的椎动脉狭窄与脑干和小脑梗死的关系。方法回顾性收集经256层螺旋CT血管成像证实有≥50%的症状性椎动脉狭窄54例，引起脑干或小脑梗死。分析症状性椎动脉狭窄的不同部位特点与脑干和小脑梗死的关系。结果椎动脉狭窄引起脑干梗死，腔隙性梗死明显多于区域性梗死(χ2=7.84，P<0.05)，引起小脑梗死，区域性梗死明显多于腔隙性梗死(χ2=10.71，P<0.01)。动脉粥样硬化斑块见于45.45%脑干梗死的患者和71.43%小脑梗死患者。椎动脉发育不良见于18.19%脑干梗死的患者和14.29%小脑梗死患者。脑干梗死组中椎动脉颅内段(V4段)狭窄占42.37%，明显高于小脑梗死组(22.44%，χ2=6.25，P<0.05)。小脑梗死组中，椎动脉颅外段(V1段)狭窄占36.73%，明显高于脑干梗死组(20.33%，χ2=5.07，P<0.05)。脑干梗死组合并基底动脉狭窄率为12.12%，明显高于小脑梗死组(4.26%，字2=4.00，P<0.05)。结论引起脑干和小脑梗死的症状性椎动脉颅内、外段狭窄部位有差异，对脑干和小脑梗死患者尽快进行有效的血管评价，对于选择药物治疗和血管内治疗有重要意义。
목적：탐토협착≥50%적추동맥협착여뇌간화소뇌경사적관계。방법회고성수집경256층라선CT혈관성상증실유≥50%적증상성추동맥협착54례，인기뇌간혹소뇌경사。분석증상성추동맥협착적불동부위특점여뇌간화소뇌경사적관계。결과추동맥협착인기뇌간경사，강극성경사명현다우구역성경사(χ2=7.84，P<0.05)，인기소뇌경사，구역성경사명현다우강극성경사(χ2=10.71，P<0.01)。동맥죽양경화반괴견우45.45%뇌간경사적환자화71.43%소뇌경사환자。추동맥발육불량견우18.19%뇌간경사적환자화14.29%소뇌경사환자。뇌간경사조중추동맥로내단(V4단)협착점42.37%，명현고우소뇌경사조(22.44%，χ2=6.25，P<0.05)。소뇌경사조중，추동맥로외단(V1단)협착점36.73%，명현고우뇌간경사조(20.33%，χ2=5.07，P<0.05)。뇌간경사조합병기저동맥협착솔위12.12%，명현고우소뇌경사조(4.26%，자2=4.00，P<0.05)。결론인기뇌간화소뇌경사적증상성추동맥로내、외단협착부위유차이，대뇌간화소뇌경사환자진쾌진행유효적혈관평개，대우선택약물치료화혈관내치료유중요의의。
Objective To investigate the correlation between ≥50% apparently symptomatic vertebral stenosis and the brainstem/cerebellar infarction. Methods 54 patients with≥50%apparently symptomatic vertebral stenosis detected by 256-multislice CT angiography (CTA) were admitted retrospectively. Vertebral stenosis resulted in brainstem/cerebellar infarction. The symptomatic vertebral artery stenosis characteristics in brainstem/cerebellar infarction were analyzed. Results Lacunar infarction in brainstem infarction group due to vertebral artery stenosis was significantly more than ter-ritorial infarction (χ2=7.84, P<0.05). Territorial infarction in cerebellar infarction group was significantly more than la-cunar infarction (χ2=10.71, P<0.01). Atherosclerotic plaques were found in 45.45%/71.43%of the cases with brainstem/cerebellar infarction respectively. Vertebral artery hypoplasia was found in 18.19%/14.29%of the cases with brainstem/cerebellar infarction respectively. The intracranial vertebral artery (V4 segment) stenosis was significantly higher in the brainstem infarction group (42.37%) than that in the cerebellar infarction group (22.44%, χ2=6.25, P<0.05). The prox-imal vertebral artery (V1 segment) stenosis was significantly higher in the cerebellar infarction group (36.73%) than that in the brainstem infarction group (20.33%, χ2=5.07, P< 0.05). The prevalence of basilar artery stenosis complicated with vertebral artery stenosis was significantly higher in the brainstem infarction group (12.12%) than that in the cere-bellar infarction group (4.26%,χ2=4.00, P<0.05). Conclusion The differences of symptomatic extra/intracranial verte-bral artery in brainstem/cerebellar infarction indicate that patients with brainstem/cerebellar infarction should be evalu-ated by image technologies effectively as soon as possible, which will provide the reliable basis of drug treatment and endovascular treatment.