Wallenberg综合征与椎动脉形态变异现象的关系研究

Relationship between Wallenberg syndrome and vertebral artery morphological variation: report of 37 cases

目的利用全脑数字减影血管造影术(digital subtraction angiography,DSA)探讨Wallenberg综合征发病与椎动脉形态变异现象之间的相关性。方法将37例Wallenberg综合征患者设为观察组,452例非Wallenberg综合征的急性脑梗死患者设为对照组,所有患者进行DSA检查,对比检测两组患者中出现单侧椎动脉优势(vertebral artery dominance,VAD)及椎动脉发育不良(vertebral artery hypoplasia,VAH)现象的分布差异,分析其血管变异与Wallenberg综合征的相互关联及优势比(odds ratio,OR)。结果观察组中有VAD现象19例(包含4例右侧VAH,2例左侧VAH);对照组中有VAD现象139例(包含16例右侧VAH,5例左侧VAH)。观察组VAD、VAH的出现率明显高于对照组(分别为χ2=6.635,P=0.010;χ2=6.699,P=0.010)。结论 VAD、VAH现象与Wallenberg综合征间存在明显关联,在其发病中可能有较为重要的意义。

Objective To investigate the correlation between Wallenberg syndrome and unilateral vertebral artery morphological variation using whole brain digital subtraction angiography（ DSA）. Methods Thirty-seven patients with Wallenberg syndrome were assigned to an observation group,and 452 cases of acute cerebral infarction patients without Wallenberg syndrome to a control group. All patients had DSA examination and their unilateral vertebral artery dominance（ VAD） and vertebral artery hypoplasia（ VAH） distribution difference was analyzed,as well as the correlation between the vascular variation and Wallenberg syndrome and the odds ratio（ OR）. Results The observation group had 19 cases with VAD（ including 4 cases of right dysplasia and 2 cases of left dysplasia）. The control group had 139 cases with VAD（including 16 cases of right dysplasia and 5 cases of left dysplasia）. VAD and VAH in the observation group were both higher than those in the control group（ χ2= 6. 635,P = 0. 010; χ2= 6. 699,P = 0. 010,respectively）,showing statistically significant difference（P〈 0. 05）. Conclusion VAD and VAH show significant correlation with Wallenberg syndrome,and may be important in the pathogenesis.