CAJ | 학술논문

目的探讨暴露于血管危险因素下的基底动脉弯曲对脑桥梗死的影响.方法连续收集2009年7月至2013年4月郑州人民医院神经内科住院经MRI诊断的急性脑桥梗死患者(88例),详细记录其临床资料及血管危险因素和NIHSS评分.据磁共振血管造影(MRA)结果分为基底动脉弯曲组(46例)和无基底动脉弯曲组(42例)；以基底动脉弯曲但非脑梗死的头晕或眩晕者(38例)为对照组.测量全部研究对象基底动脉弯曲长度(BL)和双侧椎动脉直径,将BL和椎动脉直径差异均分为3级进行分层研究.结果基底动脉弯曲组、无弯曲组与对照组比较,在年龄≥65岁[24(52.2％)、8(19.0％)与7(18.4％)]、吸烟[17/46(36.9％)、5/42(11.9％)与7/38(18.4％)]、高血压[21/46(45.7％)、12/42(28.6％)与13/38(34.2％)]、高同型半胱氨酸[15/46(32.6％)、7/42(16.7％)与3/38(7.9％)]、高胆固醇[23/46(50.0％)、6/42(14.3％)与9/38(23.7％)]及2型糖尿病[27/46(58.7％)、6/42(14.3％)与3/38(7.9％)]等病史方面,差异有统计学意义(x2值分别为5.362、3.540、3.248、3.257、4.913、6.118,均P＜0.05).校正相关危险因素后多因素分析表明,BL 3级(3.77 ～7.25 mm)是脑桥梗死的危险因素(OR =2.74,95％CI1.27 ～4.48,P＜0.05).Pearson相关性分析表明,双侧椎动脉直径差异与BL分级呈正相关(r=0.769,P＜0.01).结论暴露于血管危险因素的基底动脉弯曲将增加脑桥梗死的发生.双侧椎动脉直径差异与BL分级呈正相关,BL 3级是脑桥梗死的危险因素.
목적 탐토폭로우혈관위험인소하적기저동맥만곡대뇌교경사적영향.방법 련속수집2009년7월지2013년4월정주인민의원신경내과주원경MRI진단적급성뇌교경사환자(88례),상세기록기림상자료급혈관위험인소화NIHSS평분.거자공진혈관조영(MRA)결과분위기저동맥만곡조(46례)화무기저동맥만곡조(42례)；이기저동맥만곡단비뇌경사적두훈혹현훈자(38례)위대조조.측량전부연구대상기저동맥만곡장도(BL)화쌍측추동맥직경,장BL화추동맥직경차이균분위3급진행분층연구.결과 기저동맥만곡조、무만곡조여대조조비교,재년령≥65세[24(52.2％)、8(19.0％)여7(18.4％)]、흡연[17/46(36.9％)、5/42(11.9％)여7/38(18.4％)]、고혈압[21/46(45.7％)、12/42(28.6％)여13/38(34.2％)]、고동형반광안산[15/46(32.6％)、7/42(16.7％)여3/38(7.9％)]、고담고순[23/46(50.0％)、6/42(14.3％)여9/38(23.7％)]급2형당뇨병[27/46(58.7％)、6/42(14.3％)여3/38(7.9％)]등병사방면,차이유통계학의의(x2치분별위5.362、3.540、3.248、3.257、4.913、6.118,균P＜0.05).교정상관위험인소후다인소분석표명,BL 3급(3.77 ～7.25 mm)시뇌교경사적위험인소(OR =2.74,95％CI1.27 ～4.48,P＜0.05).Pearson상관성분석표명,쌍측추동맥직경차이여BL분급정정상관(r=0.769,P＜0.01).결론 폭로우혈관위험인소적기저동맥만곡장증가뇌교경사적발생.쌍측추동맥직경차이여BL분급정정상관,BL 3급시뇌교경사적위험인소.
Objective To investigate the effect of basilar artery (BA) bending on the occcurence of pontine infarction (PI) when exposed to vascular risk factors.Methods We consecutively collected patients with acute PI (n =88) in Zhengzhou People' s Hospital from July 2009 to April 2013 and recorded the demographic informaiton including vascular risk factors.BA bending was analyzed on MRA.Patients with dizziness or vertigo who were not diagnosed with cerebral infarction but had BA bending were set as control group(n =38).Diameter of bilateral vertebral artery (VA) and BA bending length (BL) were measured.We then compared the vascular risk factors among three groups and analyzed the effect of BL on the occcurence of PI.Results There were significant differences among PI patients with BA bending (n =46),PI patients without BA bending (n =42) and control group,concerning the rate of age above 65 years old (24(52.2％),8(19.0％)vs 7(18.4％)),history of smoking(17/46(36.9％),5/42 (11.9％) vs 7/38 (18.4％)),hypertension (21/46 (45.7％),12/42 (28.6％) vs 13/38 (34.2％)),hyperhomocysteinemia (15/46(32.6％),7/42 (16.7％)vs 3/38 (7.9％)),high cholesterol (23/46 (50.0％),6/42(14.3％) vs 9/38 (23.7 ％)) and type 2 diabetes (27/46 (58.7 ％),6/42 (14.3 ％) vs 3/38 (7.9 ％)),the difference was statistically significant (x2 value 5.362,3.540,3.248,3.257,4.913,6.118,all P ＜ 0.05).After adjusting for the relevant factors,multivariate analysis showed that BL in 3 grade (3.77-7.25 mm) was a risk factor for the presence of PI (OR =2.74,95％ CI1.27-4.48,P ＜0.05).Diameter difference of VAs and BL was significantly positive correlated(r =0.769,P ＜ 0.01).Conclusions BA bending exposed to vascular risk factors increases the probability of PI.Diameter difference of VAs is positively correlated with the BL.BL in 3 grade is a risk factor of PI.