缺血性脑血管病患者颈内动脉颅外段血管折曲的影响因素分析

Influencing factors of kinking of extracranial internal carotid artery in patients with transient ischemic attack

目的 探讨缺血性脑血管病患者颈内动脉颅外段血管折曲的影响因素. 方法 选择行DSA检查的334例缺血性脑血管病患者,根据颈内动脉颅外段血管走行分为血管折曲组（血管成角小于90°定义为血管折曲,110例）和血管无折曲组（血管成角大于90°或盘曲成环状定义为血管无折曲,224例）,根据患者年龄分为青年组（18～45岁）、中年组（46～64岁）和老年组（≥65岁）.对于可能影响患者颈内动脉颅外段血管折曲的影响因素,如性别、年龄、身高、颈动脉狭窄程度和脑血管病危险因素等进行统计学分析. 结果 单因素分析发现,患者年龄、高血压病史、吸烟史、酗酒史、身高、性别比例在血管折曲组和血管无折曲组中差异有统计学意义（P＜0.05）;logistic回归分析显示,高血压病史（OR=2.546,95%CI：1.376～4.712,P=0.003）、年龄（以18～45岁为参照组,46～64岁组OR=2.610,95%CI：1.056～6.452,P=0.038;≥65岁组OR=2.929,95%CI：1.159～7.401,P=0.023）与患者颈内动脉颅外段血管折曲有明显相关性. 结论 高血压病史和年龄是缺血性脑血管病患者颈内动脉颅外段血管折曲的重要影响因素.

Objective To investigate the influencing factors of kinking of extracranial internal carotid artery （EICA） in patients with transient ischemic attack. Methods Three hundred and thirty-four patients with ischemic cerebrovascular disease performed digital subtraction angiography （DSA） were chosen; they were divided into 2 groups according to vascular morphology through DSA detection： kinking group （angulation smaller than 90°, n=110） and non-kinking group （angulation larger than 90°, n=224）. According to the age, the patients were divided into youth group （18-45 years old）,middle age group （46-64 years old） and elderly group （older than 65 years old）. The influencing factors which may be related to the kinking of EICA, including gender, age, height and stenosis degree, and the risk factors for cerebrovascular diseases were statistically analyzed. Results Univariate analysis found that the kinking group and non-kinking group on the ratio of age, gender, height, and histories of hypertension, smoking and drinking were significantly different （P〈0.05）. Multiple logistic regression analysis showed that the kinking of EICA was obviously correlated to the history of hypertension （OR=2.546, 95% CI： 1.376-4.712, P=0.003） and age （taking youth group as reference group, middle age group：OR=2.610, 95% CI： 1.056-6.452, P=0.038, elderly group： OR=2.929, 95% CI： 1.159-7.401, P=0.023）.Conclusion The history of hypertension and age are identified as independent predictors for kinking of EICA in patients with ischemic cerebrovascular diseases.