椎基底动脉延长症合并后循环梗死患者责任斑块、责任血管特征分析

Characteristics of Responsible Plaques and Responsible Vessels in Patients with Vertebrobasilar Dolichoectasia Combined with Posterior Circulation Infarction

目的 分析椎基底动脉延长症(VBD)合并后循环梗死患者责任血管、责任血管特征。方法 选取2020年1月—2022年1月哈励逊国际和平医院收治的142例VBD合并后循环梗死患者为研究对象。收集患者的一般资料,所有患者行高分辨率磁共振血管壁成像(HRMR-VWI)检查。记录VBD合并后循环梗死患者责任斑块、责任血管特征,并比较易损斑块和稳定斑块及不同责任血管重构情况患者一般资料、HRMR-VWI参数。结果 142例VBD合并后循环梗死患者中48例(33.8%)为易损斑块,其中28例患者的易损斑块位于基底动脉(BA)、20例患者的易损斑块位于椎动脉(VA);94例(66.2%)为稳定斑块,其中45例患者的稳定斑块位于BA、49例患者的稳定斑块位于VA。142例VBD合并后循环梗死患者中责任血管正性重构99例(69.7%),负性重构30例(21.1%),无重构13例(9.2%)。易损斑块患者BA直径、VA直径大于稳定斑块患者,BA高度评分、BA水平移位评分高于稳定斑块患者(P<0.05)。负性重构患者BA直径、VA直径小于正性重构患者,BA高度评分、BA水平移位评分低于正性重构患者(P<0.05);无重构患者BA直径、VA直径小于正性重构和负性重构患者,BA高度评分、BA水平移位评分低于正性重构和负性重构患者(P<0.05)。结论 VBD合并后循环梗死患者以稳定斑块、责任血管正性重构多见,且易损斑块、责任血管正性重构患者VBD病情较严重。

Objective To analyze the characteristics of responsible plaques and responsible vessels in patients with vertebrobasilar dolichoectasia(VBD)combined with posterior circulation infarction.Methods A total of 142 patients with VBD complicated with posterior circulation infarction admitted to Harrison International Peace Hospital from January 2020 to January 2022 were selected as the study subjects.The general data of the patients were collected,and all patients underwent high-resolution magnetic resonance vascular wall imaging(HRMR-VWI)examination.The characteristics of responsible plaques and responsible vessels in patients with VBD complicated with posterior circulation infarction were recorded,and the general data and HRMR-VWI parameters were compared between vulnerable plaques patients and stable plaques patients,and patients with different responsible vascular remodeling.Results Of the 142 patients with VBD complicated with posterior circulation infarction,48 patients(33.8%)had vulnerable plaques,of which 28 were located in the basilar artery(BA)and 20 were located in the vertebral artery(VA);94 patients(66.2%)had stable plaques,of which 45 were located in the BA and 49 were located in the VA.Among 142 patients with VBD complicated with posterior circulation infarction,99 patients(69.7%)had positive remodeling of the responsible vessel,30 patients(21.1%)had negative remodeling,and 13 patients(9.2%)had no remodeling of the responsible vessel.The BA diameter and VA diameter of patients with vulnerable plaque were bigger than those of patients with stable plaque,and the BA height score and BA horizontal displacement score were higher than those of patients with stable plaque(P<0.05).The BA diameter and VA diameter of patients with negative remodeling were smaller than those of patients with positive remodeling,and the BA height score and BA horizontal displacement score were lower than those of patients with positive remodeling(P<0.05).The BA diameter and VA diameter of patients without remodeling were smaller than those of patients with positive remodeling and negative remodeling,and the BA height score and BA horizontal displacement score were lower than those of patients with positive remodeling and negative remodeling(P<0.05).Conclusion Patients with VBD combined with posterior circulation infarction are more common with stable plaques and positive remodeling of responsible vessels,and patients with vulnerable plaques and positive remodeling of responsible vessels have severe VBD.