脑动脉狭窄分布特征及其危险因素相关性分析

Analysis of the Distribution of Cerebral Artery Stenosis and the Related Risk Factors

目的探讨缺血性脑血管病患者的脑动脉狭窄分布特点及其危险因素的相关性分析。方法回顾性分析112例经CT血管成像(CTA)检查的缺血性脑血管患者的临床资料,由两名神经科医师分别对血管狭窄病变部位、程度进行统计,根据CTA结果分为颅内血管狭窄组和颅外血管狭窄组,根据狭窄程度分为轻度、中度、重度狭窄及闭塞组,并对颅内外血管狭窄水平差异及其危险因素进行相关性分析。结果 (1)在112例患者中,发生脑动脉狭窄的患者共有86例,共检出病变104处,其中颅外动脉狭窄59处(56.7%),颅内动脉狭窄45处(43.3%),颅外动脉轻、中度狭窄42处,颅内动脉中、重度狭窄36处,差异有统计学意义(P=0.015)。(2)多因素Logistic回归分析结果显示高血压(OR=3.336)、糖尿病(OR=3.620)、吸烟(OR=10.036)、高血脂(OR=3.363)是脑动脉狭窄的独立危险因素。结论颅外动脉狭窄发生率高于颅内动脉,颅外动脉狭窄以轻、中度狭窄为主,颅内动脉狭窄以中、重度为主,脑动脉狭窄与高血压、糖尿病、吸烟、高血脂等因素有关。

Objective To investigate the distribution features of cerebral artery stenosis in patients with ischemic cerebrovascular disease and the risk factors related to the stenosis. Methods The clinical data of 112 cases with ischemic cerebrovascular disease were collected. The location and degree of stenosis were statistically analyzed by two neurologists. All cases were detected by CT angiography（ CTA） and were classified into two groups： intracranial vascular stenosis and extracranial vascular stenosis group. According to the degree of arterial stenosis,stenosis group were divided into four subgroups including mild,moderate,severe stenosis and occlusion. The level of stenosis and the risk factors related to different levels of artery stenosis were analyzed. Results Among 112 cases,86 cases had artery stenosis.A total of 104 artry stenosis were detected. Extracranial artry stenosis were 59（ 56. 7%） and intracranial artery stenosis were 45（ 43. 3%）. Among of stenosis group,there were 42 cases with mild and moderate extracranial artery stenosis and36 cases with moderate and severe intracranial artery stenosis. There was statistical significance between them（ P = 0.015）. Logistic regression analysis showed hypertension（ OR = 3. 336）,diabetes（ OR = 3. 620）,smoking（ OR = 10. 036）and hyperlipemia（ OR = 3. 363） were the indepedent risk factorsfor cerebral artry stenosis. Conclusion The incidence of stenosis in extracranial artery is higher than in intracranial artery stenosis. Mild and moderate stenosis is main in extracranial artery,while moderate and severe main in intracranial artery. Hypertension,diabetes,smoking,hyperlipemia are contributed to the cerebral artery stenosis.