国际脑血管病杂志
國際腦血管病雜誌
국제뇌혈관병잡지
INTERNATIONAL JOURNAL OF CEREBROVASCULAR DISEASES
2015年
1期
16-20
,共5页
卒中%脑缺血%椎动脉%磁共振血管造影术%危险因素
卒中%腦缺血%椎動脈%磁共振血管造影術%危險因素
졸중%뇌결혈%추동맥%자공진혈관조영술%위험인소
Stroke%Brain Ischemia%Vertebral Artery%Magnetic Resonance Angiography%Risk Factors
目的 探讨椎动脉发育不全(vertebral artery hypoplasla,VAH)与后循环缺血性卒中(posterior circulation ischemia stroke,PCIS)的相关性.方法 收集2012年3月至2014年3月期间诊断为缺血性卒中并行头颅MRI和颈部三维对比增强磁共振血管造影检查的患者.VAH定义为椎动脉直径＜2 mm且全程纤细或不显影.根据发病部位分为前循环缺血性卒中(anterior circulation ischemia stroke,ACIS)组和PCIS组,对临床和影像学资料进行比较.结果 共纳入137例患者,ACIS 患者96例(70.07％),PCIS患者41例(29.93％).共有37例(27.01％)诊断为VAH,其中左侧13例,右侧24例;女性14例,男性23例.女性VHA检出率(29.17％)高于男性(25.84％),但差异无统计学意义(x2=0.175;P=0.676).PCIS组TOAST分型(x2=6.710;P=0.035)、合并缺血性心脏病(14.6％对61.5％; x2 =25.262,P＜0.001)和VAH(58.5％对13.5％; x2 =29.505,P＜0.001)与ACIS组存在显著性差异.多变量logistic回归分析显示,VAH与PCIS独立相关(优势比10.788,95％可信区间3.863 ～30.131;P＜0.001),而合并缺血性心脏病与ACIS独立相关(优势比0.082,95％可信区间0.024 ～0.278;P ＜0.001).结论 VAH在缺血性卒中患者中并不少见,可能促进了PCIS的发生.
目的 探討椎動脈髮育不全(vertebral artery hypoplasla,VAH)與後循環缺血性卒中(posterior circulation ischemia stroke,PCIS)的相關性.方法 收集2012年3月至2014年3月期間診斷為缺血性卒中併行頭顱MRI和頸部三維對比增彊磁共振血管造影檢查的患者.VAH定義為椎動脈直徑＜2 mm且全程纖細或不顯影.根據髮病部位分為前循環缺血性卒中(anterior circulation ischemia stroke,ACIS)組和PCIS組,對臨床和影像學資料進行比較.結果 共納入137例患者,ACIS 患者96例(70.07％),PCIS患者41例(29.93％).共有37例(27.01％)診斷為VAH,其中左側13例,右側24例;女性14例,男性23例.女性VHA檢齣率(29.17％)高于男性(25.84％),但差異無統計學意義(x2=0.175;P=0.676).PCIS組TOAST分型(x2=6.710;P=0.035)、閤併缺血性心髒病(14.6％對61.5％; x2 =25.262,P＜0.001)和VAH(58.5％對13.5％; x2 =29.505,P＜0.001)與ACIS組存在顯著性差異.多變量logistic迴歸分析顯示,VAH與PCIS獨立相關(優勢比10.788,95％可信區間3.863 ～30.131;P＜0.001),而閤併缺血性心髒病與ACIS獨立相關(優勢比0.082,95％可信區間0.024 ～0.278;P ＜0.001).結論 VAH在缺血性卒中患者中併不少見,可能促進瞭PCIS的髮生.
목적 탐토추동맥발육불전(vertebral artery hypoplasla,VAH)여후순배결혈성졸중(posterior circulation ischemia stroke,PCIS)적상관성.방법 수집2012년3월지2014년3월기간진단위결혈성졸중병행두로MRI화경부삼유대비증강자공진혈관조영검사적환자.VAH정의위추동맥직경＜2 mm차전정섬세혹불현영.근거발병부위분위전순배결혈성졸중(anterior circulation ischemia stroke,ACIS)조화PCIS조,대림상화영상학자료진행비교.결과 공납입137례환자,ACIS 환자96례(70.07％),PCIS환자41례(29.93％).공유37례(27.01％)진단위VAH,기중좌측13례,우측24례;녀성14례,남성23례.녀성VHA검출솔(29.17％)고우남성(25.84％),단차이무통계학의의(x2=0.175;P=0.676).PCIS조TOAST분형(x2=6.710;P=0.035)、합병결혈성심장병(14.6％대61.5％; x2 =25.262,P＜0.001)화VAH(58.5％대13.5％; x2 =29.505,P＜0.001)여ACIS조존재현저성차이.다변량logistic회귀분석현시,VAH여PCIS독립상관(우세비10.788,95％가신구간3.863 ～30.131;P＜0.001),이합병결혈성심장병여ACIS독립상관(우세비0.082,95％가신구간0.024 ～0.278;P ＜0.001).결론 VAH재결혈성졸중환자중병불소견,가능촉진료PCIS적발생.
Objectve To investigate the correlation between vertebral artery hypoplasia (VAH) and posterior circulation ischemic stroke (PCIS).Methods The patients who were diagnose as ischemic cerebral stroke and underwent brain magnetic resonance imaging and cervical three-dimensional contrast-enhanced magnetic resonance angiography from March 2012 to March 2014 were enrolled.VAH was defined as vertebral artery diameter ＜ 2 mm and thin or did not develop.They were divided into either an anterior circulation ischemic stroke (ACIS) group or a PCIS group according to the sites of disease.The clinical and imaging data were compared.Results A total of 137 patients were enrolled,including 96 patients (70.07％) with ACIS and 41 (29.93％) with PCIS.Thirty-seven patients were (27.01％) diagnosed as VAH,including 13 on the left and 24 on the right; 14 females and 23 males.The detection rate of females (29.17％) was higher than that of males (25.84％),but the difference was not statistically significant (x2 =0.175; P =0.676).There were significant differences in TOAST classificanon (x2 =6.710; P =0.035),combined with ischemic heart disease (14.6％ vs.61.5％ ; x2 =25.262,P ＜ 0.001) and VAH (58.5％ vs.13.5％ ; x2 =9.505,P ＜0.001) between the PCIS group and the ACIS group.Multivariable logistic regression analysis showed that VAH was independently correlated with PCIS (odds ratio 10.788,95％ confidence interval 3.863-30.131; P ＜ 0.001),and combined with ischemic heart disease was independently correlated with ACIS (odds ratio 0.082,95％ confidence interval 0.024-0.278; P ＜ 0.001).Conclusions VAH is not rare in patients with ischemic stroke.It may promote the occurrence of PCIS.
