379例急性椎基底动脉系统脑梗死患者的临床诊断及病因分析

Clinical analysis of the diagnosis and etiology of 379 patients with vertebrobasilar infarction

目的：分析379例急性椎基底动脉系统脑梗死患者的临床特征。方法选取南京卒中注册系统中急性椎基底动脉系统脑梗死的病例共379例，所有患者均行CT／MRI、超声心动图及血生化实验室等相关检查。患者行CTA／MRA／DSA、血管超声等脑血管检查。结果椎基底动脉系统脑梗死患者中头晕伴／不伴视物旋转、言语不清是最常见的首发症状。大动脉粥样硬化型脑梗死最为常见（53．6％），梗死部位以桥脑、小脑最为常见。55．4％患者存在血管病变，其中椎动脉起始部病变最常见。结论全面认识椎基底动脉系统脑梗死的临床特征对于早期诊断、早期治疗及预防至关重要。

Objective To study the clinical characteristics of the vertebrobasilar infarction patients.Methods 379 patients with actue vertebrobasilar infarction were extracted from Nanjing Stroke Registry Program.Some auxiliary examinations, such as computerized tomography （ CT ）/magnetic resonance imaging （ MRI ） , ultrasound cardiography and so on, were performed in all patients. Computerized tomography angiographies （ CTA ） , magnetic resonance imaging angiography （ MRA ） or digital subtraction angiography （ DSA） were performed in the patients.Results Dizziness/vertigo and barylalia were the most common initial symptom.Referring to TOAST classification, large -artery atherosclerosis was the most common mechanism （53.6%）.55.4% patients had vascular anomalies, and there were 27.4%lesions in ostial vertebral artery.Conclusion It is important to study the clinical characteristics of vertebrobasilar infarction for its early diagnosis, early treatment and secondary prevention.