老年人头晕与椎基底动脉硬化狭窄的关系及其危险因素

Relationship between elderly people dizzy and vertebrobasilar artery atherosclerotic stenosis with risk factors

目的研究老年人头晕与椎基底动脉硬化狭窄的相关性,分析其危险因素,指导临床治疗和预防。方法将101例老年头晕患者设为观察组,100例同期到门诊就诊和住院的其它疾病患者和正常体检者设为对照组,两组患者均进行脑血管MRA检查和血脂、血糖、凝血四项检查,调查既往病史,随访追踪6个月。结果老年头晕患者椎基底动脉硬化狭窄检出率为81.2%,对照组为22%,两组比较有显著性差异(P<0.01),老年人发生头晕和椎基底动脉硬化狭窄者多合并有高血压、糖尿病(P<0.05),观察组纤维蛋白原(FIB)较对照组高(P<0.05),国际标准化比值(INR)较对照组低(P<0.05),椎基底动脉硬化狭窄者甘油三脂(TG)、胆固醇(CH)、低密度脂蛋白(LDL)较非狭窄者高(P<0.05),高密度脂蛋白(HDL)较非狭窄者低(P<0.05),随访6个月老年头晕患者给予治疗后约66.3%(67例)头晕缓解,33.7%(34例)发展为后循环梗死,对照组发生后循环梗死者4例(4%)。结论椎基底动脉硬化狭窄是导致老年人头晕的重要原因,国际标准化比值低(INR)和纤维蛋白原高(FIB)也是老年人头晕的危险因素。甘油三脂、胆固醇、低密度脂蛋白(LDL)增高和高密度脂蛋白(HDL)低是椎基底动脉硬化狭窄的危险因素。MRA作为无创性的诊断技术可用于筛选和随访椎基底动脉硬化狭窄患者。老年人出现头晕应积极查找原因,给予治疗以防发生后循环梗死。

Objective To study the relationship between elderly people dizzy and vertebrobasilar artery atherosclerotic stenosis,analyze the risk factors of vertebrobasilar artery atherosclerotic stenosis and guide clinical treatment and prevention.Methods 101 cases elder dizzy patients（observation group） were enrolled controlled with 100 cases of outpatient service and hospitalized and other medical check-up（control group）.The patients were checked with cerebrovascular MRA.The lipid,blood sugur,blood coagulation were measured.Results The rate of vertebrobasilar artery atherosclerotic stenosis in the observation group and control group were 81.2% and 22%（P〈0.01）.The elder people with dizzy and vertebrobasilar artery atherosclerotic stenosis had high hypertension and diabetes（P〈0.05）.The fibrinogen（FIB） in the observation group was higher than thatin control group（P〈0.05）.The international standardization ratio（INR） in the observation group was lower than that in the control group（P〈0.05）.The triglycerides（TG）,cholesterol（CH） and low-density lipoprotein（LDL） of the vertebrobasilar artery atherosclerotic steno sis patients were higher than that in the normal vertebrobasilar artery group（P0 .05）.Conclusion Vertebrobasilar artery atherosclerotic stenosis is the important reason of elder people dizzy,low international standardization ratio（INR） and high fibrinogen（FIB） are two risk factors.Triglyceride（TG）,cholesterol（CH） and low-density lipoprotein（LDL） high and high-density lipoprotein（HDL） low are the risk factors of vertebrobasilar artery atherosclerotic stenosis.As a noninvasive diagnostic technology MRA can be used for screening and follow-up vertebrobasilar artery atherosclerotic stenosis patients.