胚胎型大脑后动脉与短暂性脑缺血发作

Fetal-type posterior cerebral artery and Transient ischemic attack

目的：探讨胚胎型大脑后动脉（Fetal-type posterior cerebralartery，FTP）与短暂性脑缺血发作（TIA）的关系。方法：收集2015年9月～2017年7月期间住院治疗的TIA患者185例的临床资料。所有患者均行颅脑CT、颅脑MRI＋弥散加权成像（DWI）＋磁共振血管造影（MRA）检查。根据MRA结果分为FTP组和非FTP组，根据英国牛津郡社区脑卒中项目（oxfordshire community strokeproject，OCSP）的分型标准将TIA分为前循环TIA和后循环TIA，根据FTP出现在一侧或双侧分为单侧FTP和双侧FTP。采用多变量logistic回归分析探讨FTP与TIA的相关性。结果：纳入研究的185例患者中，男性93例，女性92例；前循环TIA组63例，后循环TIA组122例。共52例（28．1％）存在FTP，男性诊断FTP21例，女性诊断FTP31例，女性FTP检出率（33．7％）高于男性（22．6％），但差异无统计学意义（χ2=2．828，P=0．093）。后循环TIA性别（χ2=8．381，P=0．004）、糖尿病（χ2=6．199，P=0．013）、高同型半胱氨酸（χ2=4．927，P=0．026）、FTP（χ2=7．077，P=0．008）与前循环TIA之间差异有统计学意义。多变量Logistic回归分析显示，女性（OR=2．228，95％CI1．124-4．417；P=0．022）、FTP（OR=2．624，95％CI1．167～5．900；P=0．02）是后循环TIA的独立危险因素，而糖尿病（OR一0．343，95％C10．137-O．856；p=0．022）是前循环TIA的独立危险因素。结论：FTP在TIA患者中并不少见，可能促进了后循环TIA的发生。女性患者合并FTP，更易发生后循环TIA。

Objective：To investigate the associations of fetal-type posterior cerebral artery （FTP） and transient ischemic attack （TIA）. Methods：The consecutive patients with TIA hospitalized from Sep tember 2015 to July 2017 were collected. All patients underwent CT, MRI ,diffusion weighted imaging （DWI）and magnetic resonance angiography （MRA）. They were divided into either the FTP group or the non-FTP group according to the results of magnetic resonance imaging. According to Oxfordshire com- munity stroke project （OCSP）classification standards, all patients with TIA were divided into the cases of anterior circulation TIA and posterior circulation TIA. According to the position of FTP the patients were divided into the cases of one-side FTP and bilateral FTP. Multivariate logistic regression analysis was conducted to determine the associations of FTP with TIA. Results.. Of 185 patients with TIA in volved （93 male and 92 female, including 63 cases in the anterior circulation group and 122 cases in the posterior circulation group there were 52 （28.1%） cases with FTP （21 male and 31 female）. The detec- tion rate of female cases （33.7 % ） was higher than that of male ones （22.6 % ）, but the difference was not statistically significant（χ2 = 2. 828, P= 0. 093）. There were significant differences in gender （ χ2 = 8. 381,P=0. 004）, diabetes （χ2=6. 199, P = 0. 013）, Hyperhomocysteinaemia （χ2 = 4. 927, P = 0. 026） and FTP（χ2= 7. 077, P = 0. 008） between the posterior circulation TIA and the anterior circulation TIA. Multivariable logistic regression analysis showed that the female （odds ratio 2. 228,95%, confidence in- terval 1. 124-4. 417%;P=0. 022） and FTP （OR 2. 624,95%, CI 1. 167-5. 900; P=0.02） were inde- pendently correlated with posterior circulation TIA, and combined with diabetes （OR 0. 343,95%, CI 0.137 - 0. 856 ; P = 0. 022） was independently correlated with anterior circulation TIA. Conclusion ： FTP is not rare in patients with TIA. It may promote the occurrence of posterior circulationTIA. Female pa- tients with FTP are more likely to have posterior circulation TIA.