椎基底动脉扩张延长症发病的危险因素研究

A study of the risk factors of the onset of vertebrobasilar dolichoectasia

目的研究椎基底动脉扩张延长症发病的危险因素。方法选取120例2016年9月~2019年9月我院收治的脑梗死患者为研究对象,根据CTA或MRA检查诊断分为两组,非VBD患者60例为对照组,VBD患者60例为试验组,采取经颅多普勒检查;比较两组患者发病危险因素。以椎基底动脉扩张延长症发病情况为二分类因变量,自变量为年龄≥60岁、有吸烟史、高血压、高脂血症、冠心病、脑卒中、饮酒史、高尿酸血症、TC、TG、LDL-C、HDL-C为自变量,进行多因素Logistic回归分析。结果两组患者危险因素除糖尿病、BIM、性别指标为差异无统计意义(P>0.05),其余指标试验组均高于对照组,差异有统计学意义(P<0.05)。试验组的脑血流动力学特征所表现出的椎基底动脉收缩期峰值血流速度、收缩/舒张比值低于对照组,对照组峰值平均血流速度、搏动指数、阻力指数均高于试验组,差异有统计学意义(P<0.05)。年龄≥60岁、有吸烟史、高血压、高脂血症、冠心病、脑卒中、饮酒史、高尿酸血症、TC、TG、LDL-C、HDL-C均为椎基底动脉扩张延长症发病的危险因素。结论在临床中可引起椎基底动脉扩张的危险因素较多,尤其是患有多种合并疾病、有吸烟史、年龄较高的患者应及时做好护理干预,同时患有脑梗死应对椎基底动脉扩张尽早做诊断,以便提早预防治疗。

Objective To study the risk factors of the onset of vertebrobasilar dolichoectasia(VBD).Methods 120 patients with cerebral infarction(CI)admitted to and treated in our hospital from September 2016 to September 2019 were selected as the subjects of research,and were divided into two groups according to CTA or MRA test and diagnosis.60 non-VBD patients were taken as the control group,and 60 patients with VBD were taken as the experimental group,both of which received transcranial Doppler(TCD)examination.The risk factors of the onset of diseases for the two groups were studied and compared.Multivariate Logistic regression analysis was conducted with the onset of VBD as a binary dependent variable,and the age≥60,smoking history,hypertension,hyperlipidemia,coronary heart disease(CHD),cerebral apoplexy,drinking history,hyperuricemia,TC,TG,LDL-C,HDL-C as independent variables.Results Among the risk factors for the two groups,except diabetes mellitus(DM),BIM and gender index in which there was no statistically significant difference(P>0.05),the indexes in the experimental group were higher than those in the control group,and the differences were statistically significant(P<0.05).The peak systolic blood flow velocity and systolic/diastolic ratio of vertebrobasilar artery in the experimental group shown by cerebral hemodynamic characteristics were lower than those in the control group,while the peak average blood flow velocity,pulsatility index(PI)and resistance index(RI)in the control group were all higher than those in the experimental group,and the differences were statistically significant(P<0.05).The age≥60,smoking history,hypertension,hyperlipidemia,CHD,cerebral apoplexy,drinking history,hyperuricemia,TC,TG,LDL-C,and HDL-C were all risk factors of the onset of VBD.Conclusion There are many risk factors of the onset of VBD in clinical practice,especially for older patients with multiple combined diseases and smoking history,for whom nursing intervention should be done in time.Meanwhile,the patients with CI should be diagnosed as early as possible for vertebrobasilar artery dilation to prevent and treat it in advance.