椎动脉颅内段动脉粥样硬化狭窄的危险因素及临床特点

The Risk Factors and Clinical Features of Intracranial Vertebral Artery Atherosclerosis Stenosis

目的研究椎动脉颅内段狭窄的临床及影像表现。方法回顾性分析2013年6月至2015年1月因椎动脉颅内段≥50%狭窄或闭塞就诊于我科的脑血管病患者的临床及影像资料,依据是否双侧椎动脉颅内段病变分为双侧病变组和单侧病变组,比较两组间危险因素、临床及影像表现的差异性。结果共入组88例合格患者,男性75例(85.2%),女性13例(14.8%),平均年龄(61.44±9.62)岁。单侧病变患者36例(40.9%),双侧病变52例(59.1%)。14例(15.9%)伴发大脑中动脉病变,11例(12.5%)伴发基底动脉病变。双侧病变组平均年龄(65.69±8.88)岁,明显高于单侧病变组(58.50±9.06)岁,P=0.000。单侧病变组最多见起病形式为TIA(50.0%)、双侧病变组为TIA后卒中(53.8%),两组间起病形式构成比有明显统计学意义(P=0.000)。双侧病变组多发性脑梗死比例明显高于单侧病变组(64.3%vs 8.3%),差异有明显统计学意义(P=0.001)。结论椎动脉颅内段粥样硬化狭窄或闭塞以双侧受累多见,容易伴发基底动脉和大脑中动脉狭窄,双侧椎动脉病变患者比单侧椎动脉病变患者更容易表现为TIA后卒中及多发性脑梗死。

Objective To research the clinical and imaging presentation of intracranial vertebral artery stenosis.Method We retrospectively review the clinical and imaging information of patients who admitted in our department due to intracranial artery≥50%stenosis or obstruction.patients were divided into bilateral group and unilateral group according to quantity of lesions.Then the risk factors,clinical and imaging presentatin were compared.Results 88 eligible cases including 75 men（85.2%）and 13 women（14.8%）were enrolled,the average age is 61.44±9.62 years.There are 36 patients（40.9%）in unilateral group and52 patients（59.1%）in bilateral group.14 patients（15.9%）had middle cerebral artery lesions and 11 patients（12.5%）had basilar artery lesions.Patients in bilateral group had a higher average age than unilateral group（65.69±8.88 years vs 58.50±9.06 years,P=0.000）.The most common pathogenic form is TIA（50.0%）in unilateral group and stroke after TIA（53.8%）in bilateral group,statistical difference was found between two groups（P=0.000）.Bilateral group had a higher prevalence of multiple cerebral infarction than unilateral group（64.3% vs 8.3%,P=0.001）.Conclusion Patients with vertebral artery disease were often bilateral and had basilar artery or middle cerebral artery stenosis.Bilatera vertebral artery disease more often result in stroke after TIA and multiple cerebral infarction than unilateral vertebral artery lesions.