弥漫性颅内动脉延长扩张症与椎基底动脉延长扩张症比较分析

Comparison of diffuse intracranial dolichoectasia and vertebasilar dolichoectasia

目的探讨分析弥漫性颅内动脉延长扩张症(DID)和椎基底动脉延长扩张症(VBD)发病的影响因素、临床特点和预后转归。方法选择2015年1月至2018年8月温岭市第一人民医院经头颅CT、MRI、CTA、DSA、MRA等影像学检查确诊的颅内动脉延长扩张症(IADE)患者34例,将其分为椎基底动脉延长扩张症(VBD组)24例,DID组10例。比较两组患者性别、年龄、吸烟、饮酒、合并脑卒中、高血压、糖尿病、冠心病及其他动脉疾病的情况、通过影像学检测比较两组患者病变动脉分布特点,对两组患者进行随访,分析比较病情稳定、恶化的情况。结果与VBD组患者比较,DID组患者中吸烟、饮酒的比例(60%比20.8%、70.0%比33.3%)更高,合并脑卒中、高血压、糖尿病、冠心病及其它动脉疾病的比例更大(50.0%比20.8%、80.0%比33.3%、60.0%比16.7%、30.0%比0、70.0%比25.0%),DID患者颅内动脉延长扩张的部位更多,颅外动脉延长扩张的比例更高(70.0%比25.0%),稳定患者的比例较低(30.0%比91.7%),差异均有统计学意义(P<0.05)。结论DID患者相较VBD患者吸烟、饮酒、高血压病、糖尿病及其它动脉疾病更多,预后更差,死亡率更高,提示其病情的进展、恶化程度可能更快、更严重,对各种治疗的反应可能更差。

Objective To investigate the risk factors,clinical features,and prognosis of diffuse intracranial dolichoectasia(DID)and vertebrobasilar dolichoeatsia(VBD).Methods Thirty four patients with intracranial arterial dolichoectasia(IADE)diagnosed by CT,CTA,MRI,MRA,DSA and other imaging examinations in Wenling First People's Hospital from January 2015 to August 2018 were enrolled,including 24 cases of VBD and 10 cases of DID.The gender,age,history of smoking and drinking,comorbidities(stroke,hypertension,diabetes,coronary heart disease,other arterial diseases)in two groups were analyzed.The distribution characteristics of diseased arteries were compared between the two groups by imaging detection.The two groups of patients were followed up to analyze and compare the stable and deteriorating conditions.Results Compared with VBD group,the ratio of smoking and drinking in DID group was higher(60%vs.20.8%,70.0%vs.33.3%),the ratio of combining with stroke,hypertension,diabetes,coronary heart disease,other arterial diseases was greater(50.0%vs 20.8%,80.0%vs 33.3%,60.0%vs 16.7%,30.0%vs 0,70.0%vs 25.0%),In patients with DID,the location of intracranial artery extension and expansion was more,and the proportion of extracranial artery was higher(70.0%vs.25.0%),The proportion of stable patients was lower(30.0%vs.91.7%),The differences were statistically significant(P<0.05).Conclusion Compared with VBD patients,DID patients have more smoking,drinking,stroke,hypertension,diabetes and other arterial diseases,worse prognosis and higher mortality rate,suggesting that the progress and deterioration of the disease may be faster and more serious,and the response to various treatments may be worse.