脑桥缺血性脑卒中患者基底动脉弯曲状况的临床分析

A clinical analysis on basilar artery curvature in patients with ischemic stroke in pons

目的探究基底动脉弯曲及椎动脉优势对脑桥缺血性脑卒中发生的影响。方法选择135例脑桥缺血性脑卒中患者,分析其影像学资料、基底动脉弯曲状况以及椎动脉优势情况,探讨导致中重度基底动脉弯曲发生的危险因素。结果弯曲组和不弯曲组在是否吸烟、是否伴有2型糖尿病、合并原发性高血压、高血脂症以及是否有既往脑卒中史上存在明显差异,同时两组的年龄及右侧椎动脉直径也有显著差异(P<0.05)。中重度弯曲组的右侧椎动脉直径(1.39±0.38)mm,明显小于轻度弯曲组的(1.73±0.46)mm(P<0.05)。而轻度弯曲组与中重度弯曲组在年龄以及原发性高血压上也存在显著差异(P<0.05)。在椎动脉直径差异级别上,中重度弯曲组3级的构成比显著高于轻度弯曲组,而1级的构成比显著低于轻度弯曲组(P<0.05)。结论年龄偏大、合并原发性高血压以及两侧椎动脉直径增大,都在一定程度上造成了基底动脉弯曲程度的加重,这些因素的共同作用促进了脑桥缺血性脑卒中的发生。

Objective To explore the effect of basilar artery curvature and vertebral artery dominance on the occurrence of ischemic stroke in pons. MeAods A total of 135 patients with ischemic stroke in pons were selected and an analysis was made on their imaging data, basilar artery curvature and vertebral artery dominance to find the risk factors that cause the moderate to severe basilar artery curvature. R枕ults There were significant differences in whether or not the patients smoked and were complicated with type-2 diabetes mellitus, primary hypertension and hyperlipidemia, and whether they had a history of previous stroke between the curvature group and non-curvature group; besides, there were significant differences in the age and the diameter of right vertebral artery between the two groups （P 〈 0.05）. The diameter of right vertebral artery being （1.39±0.38）mm in the moderate to severe curvature group was significantly lower than that in the slight curvature group, which was （1.73±0.46）mm （P〈 0.05）. There were also significant differences in the age and primary hypertension between these two groups （P 〈 0.05）. In terms of the diameter variation of vertebral artery, the proportion of level-3 variation in the moderate to severe curvature group was significantly higher than that in the slight curvature group, while the proportion of level-1 variation was significantly lower than that in the slight curvature group （P 〈 0.05）. Conclusion To some extent, senility, complication with primary hypertension and diameter increase in bilateral vertebral arteries will aggravate the basilar artery curvature, and the combined effect of such factors will promote the occurrence of ischemic stroke in pons.