椎动脉优势现象与后循环梗死相关性分析

Analysis of Correlation of Vertebral Artery Dominance and Posterior Circulation Infarction

目的探讨椎动脉优势(vertebral artery dominance VAD)与后循环梗死的相关性及伴有VAD患者后循环梗死的危险因素。方法选取2011年10月至2012年10月期间在杭州市第一人民医院神经内科收治的脑梗死患者,根据脑血管影像学检查结果分为VAD组和非VAD组,根据牛津郡社区卒中项目分型标准分为前循环组和后循环组。回顾性收集人口统计学、动脉粥样硬化危险因素、影像学和其他临床资料并进行分析比较。结果后循环梗死组伴有VAD的危险比前循环梗死组高4.68倍,而存在VAD的病例出现后循环梗死的危险是没有该血管变异者的3.17倍。基底动脉弯曲与VAD患者后循环梗死差异具有统计学意义(P<0.01)。结论 VAD与后循环梗死可能存在相关性,基底动脉弯曲可能是VAD患者后循环梗死的危险因素。

Objective To investigate the correlativity between posterior circulation infarction and vertebral artery dominance （VAD） and the risk factors of posterior circulation infarction in patients with VAD. Methods Patients with acute cerebral infarction were se- lected, which were hospitalized from October 2011 to October 2012 in neurology of the first people＇ s hospital of hangzhou. Based on the results of cerebrovascular imaging examination, all of the patients were divided into two groups： patients with VAD and patients without VAD. According to Oxfordshire community stroke project classification standards, all patients were divided into group of ante- rior circulation and group of posterior circulation. Atherosclerosis risk factors, imaging and other clinical information of these patients were retrospectively collected and compared. Results The number of patients with posterior circulation infarction was 4. 684 times higher than patients with anterior circulation infarction, and the risk of posterior circulation infarction in patients with VAD was 3.170 times higher than patients without VAD. Multivariate logistic regression analysis showed that distortion in base artery was the indepen- dent risk factor for posterior circulation infarction in patients with VAD （ P 〈 0.01 ）. Conclusions VAD may be associated with poste- rior circulation infarction. Distortion in base artery may be the independent risk factor for Posterior circulation infarction in patients with VAD.