内蒙古医学杂志
內矇古醫學雜誌
내몽고의학잡지
Inner Mongolia Medical Journal
2015年
10期
1157-1160
,共4页
白雪%张晶晶%刘丽%高晓梅
白雪%張晶晶%劉麗%高曉梅
백설%장정정%류려%고효매
椎动脉狭窄%血流动力学
椎動脈狹窄%血流動力學
추동맥협착%혈류동역학
vertebral artery stenosis%hemodynamics
目的:探讨椎动脉起始处狭窄斑块形态及血流动力学异常对后循环缺血的影响,为后循环缺血的治疗提供决策依据。方法回顾性分析2012年6月至2015年1月我院神经内科住院的椎动脉起始处狭窄≥70%的患者临床资料,依据患者临床表现及头颅MRI或平扫CT结果将全部患者分为卒中组和非卒中组,比较两组间椎动脉起始处斑块形态、性质以及血流动力学影响因素(双侧病变、串联病变、椎动脉基底动脉化、willi环完整性)的差异性。结果共256例合格患者入组,其中男性211例(82.4%),女性45例(17.6%),平均年龄(64.5±8.2)岁。卒中组与非卒中组相比,平均年龄低于非卒中组(62.4 vs 65.5岁),差异有明显统计学意义(P=0.003),并且卒中组患者既往卒中史比例高于非卒中组(23.3% vs 10.6%,P=0.007),差异有统计学意义。卒中组双侧病变患者较非卒中组多(69.8% vs 31.2%),差异有统计学意义(P=0.000);卒中组串联病变患者多于非卒中组(43.0% vs 20.0%),差异有显著统计学意义(P=0.000);卒中组不规则斑块出现率高于非卒中组(46.5% vs 25.9%),两组间比较有明显统计学意义(P=0.001)。结论对于椎动脉起始处≥70%的狭窄患者,双侧椎动脉严重狭窄、串联狭窄、不规则斑块与后循环缺血相关,对此类患者,应予以更积极的治疗。
目的:探討椎動脈起始處狹窄斑塊形態及血流動力學異常對後循環缺血的影響,為後循環缺血的治療提供決策依據。方法迴顧性分析2012年6月至2015年1月我院神經內科住院的椎動脈起始處狹窄≥70%的患者臨床資料,依據患者臨床錶現及頭顱MRI或平掃CT結果將全部患者分為卒中組和非卒中組,比較兩組間椎動脈起始處斑塊形態、性質以及血流動力學影響因素(雙側病變、串聯病變、椎動脈基底動脈化、willi環完整性)的差異性。結果共256例閤格患者入組,其中男性211例(82.4%),女性45例(17.6%),平均年齡(64.5±8.2)歲。卒中組與非卒中組相比,平均年齡低于非卒中組(62.4 vs 65.5歲),差異有明顯統計學意義(P=0.003),併且卒中組患者既往卒中史比例高于非卒中組(23.3% vs 10.6%,P=0.007),差異有統計學意義。卒中組雙側病變患者較非卒中組多(69.8% vs 31.2%),差異有統計學意義(P=0.000);卒中組串聯病變患者多于非卒中組(43.0% vs 20.0%),差異有顯著統計學意義(P=0.000);卒中組不規則斑塊齣現率高于非卒中組(46.5% vs 25.9%),兩組間比較有明顯統計學意義(P=0.001)。結論對于椎動脈起始處≥70%的狹窄患者,雙側椎動脈嚴重狹窄、串聯狹窄、不規則斑塊與後循環缺血相關,對此類患者,應予以更積極的治療。
목적:탐토추동맥기시처협착반괴형태급혈류동역학이상대후순배결혈적영향,위후순배결혈적치료제공결책의거。방법회고성분석2012년6월지2015년1월아원신경내과주원적추동맥기시처협착≥70%적환자림상자료,의거환자림상표현급두로MRI혹평소CT결과장전부환자분위졸중조화비졸중조,비교량조간추동맥기시처반괴형태、성질이급혈류동역학영향인소(쌍측병변、천련병변、추동맥기저동맥화、willi배완정성)적차이성。결과공256례합격환자입조,기중남성211례(82.4%),녀성45례(17.6%),평균년령(64.5±8.2)세。졸중조여비졸중조상비,평균년령저우비졸중조(62.4 vs 65.5세),차이유명현통계학의의(P=0.003),병차졸중조환자기왕졸중사비례고우비졸중조(23.3% vs 10.6%,P=0.007),차이유통계학의의。졸중조쌍측병변환자교비졸중조다(69.8% vs 31.2%),차이유통계학의의(P=0.000);졸중조천련병변환자다우비졸중조(43.0% vs 20.0%),차이유현저통계학의의(P=0.000);졸중조불규칙반괴출현솔고우비졸중조(46.5% vs 25.9%),량조간비교유명현통계학의의(P=0.001)。결론대우추동맥기시처≥70%적협착환자,쌍측추동맥엄중협착、천련협착、불규칙반괴여후순배결혈상관,대차류환자,응여이경적겁적치료。
Objective To investigate the influence on posterior circulation ischemia caused by atheroscle-rotic plaque morphology and hemodynamic disorder ,in order to provide influence for the treatment of posterior circulation ischemia .Methods A retrospective research was carried out ,in which informations of patients with≥7 0% stenosis of vertebral artery ostium were collected and patients were divided into stroke group and non-stroke group according to clinical presentation and head MRI or CT scan ,comparing difference of two groups about plaque morphology and nature located vertebral artery ostium ,factors affected hemodynamics w hich in-clude bilateral lesions ,tandem lesions ,basilarization of vertebral artery and status of the circle of Willis .Results 2 5 6 eligible cases including 2 1 1 men(8 2 .4% ) and 4 5 women(1 7 .6 ) were enrolled ,the average age is 6 4 .5 ± 8 .2 years ,there is a statistical difference of average ages between two groups (6 2 .4 years VS 6 5 .5 years ,P=0 .0 0 3 ) ,and stroke group has a higher incidence of previous stroke history (2 3 .3% VS 1 0 .6% ,P= 0 .0 0 7 ) . There are statistical difference among two groups about bilateral lesions(6 9 .8% VS 3 1 .2% ,P=0 .0 0 0 ) ,tandem lesions(4 3 .0% vs 2 0 .0% ,P=0 .0 0 0 ) and irregular plaques(4 6 .5% vs 2 5 .9% ,P=0 .0 0 1 ) .Conclusion As patients have ≥7 0% stenosis of vertebral artery ,there are significant correlation between bilateral lesions ,tan-dem lesions ,irregular plaques and posterior circulation ischemia ,more attention should be paid for those pa-tients .