急性脑梗死患者基底动脉弯曲的相关影响因素分析

Analysis of influencing factors of basilar artery tortuosity in patients with acute cerebral infarction

目的探讨急性脑梗死患者基底动脉弯曲的相关影响因素。方法对宿迁市第一人民医院2018年10月至2020年7月神经内科收治的129例急性脑梗死患者的临床资料进行回顾性分析,根据基底动脉弯曲与否分为弯曲组(71例)与非弯曲组(58例),分析两组患者的临床基本资料,包括年龄、性别、影像学特点等,比较两组患者后循环脑梗死发生率,同时对两组患者在椎动脉优势、高血压、糖尿病、吸烟史、饮酒史、颈动脉狭窄等方面进行比较。结果基底动脉弯曲组后循环脑梗死的发生率明显高于非弯曲组,差异有统计学意义(χ2=10.903,P<0.05);基底动脉弯曲组左椎动脉优势、双侧颈动脉狭窄、中重度颈动脉狭窄比例明显高于非弯曲组,差异有统计学意义(χ2=4.203、5.350、5.240,P<0.05);基底动脉弯曲组与非弯曲组在高血压、糖尿病、吸烟史、饮酒史等方面差异无统计学意义;多因素Logistic回归分析显示,基底动脉弯曲与左椎动脉优势、中重度颈动脉狭窄相关[OR(95%CI)=2.779(1.271~6.078)、1.911(1.162~3.143),P<0.05]。结论基底动脉弯曲患者容易发生后循环脑梗死,基底动脉弯曲脑梗死患者与左椎动脉优势及中重度颈动脉狭窄相关。

Objective To investigate the influencing factors of basilar artery tortuosity of patients with acute cerebral infarction.Methods Clinical data of 129 patients with acute cerebral infarction admitted to the department of neurology of Suqian First Hospital from October 2018 to July 2020 were retrospectively analyzed.The patients were divided into the tortuosity group(n=71)and non-tortuosity group(n=58)according to whether the basilar artery was tortuous or not.Basic clinical information of the two groups including age,gender,imaging characteristics,etc.,were analyzed.The incidence of posterior circulation cerebral infarction was compared between the two groups,meanwhile,the vertebral artery dominance,hypertension,diabetes,smoking history,drinking history and carotid artery stenosis of two groups were also compared.Results The incidence of posterior circulation cerebral infarction in the tortuosity group was significantly higher than that in the non-tortuosity group(χ2=10.903,P<0.05).The proportions of vertebral artery dominance,bilateral carotid artery stenosis and moderate to severe carotid artery stenosis in the tortuosity group were higher than those in the nontortuosity group,and the differences were statistically significant(χ2=4.203,5.350,5.240;P<0.05).However,there was no significant difference in hypertension,diabetes,smoking history,drinking history between the two groups.Multivariate logistic regression analysis showed that basilar artery tortuosity was significantly correlated with vertebral artery dominance and moderate to severe carotid artery stenosis[OR(95%CI)=2.779(1.271-6.078),1.911(1.162-3.143);P<0.05].Conclusion Patients with basilar artery are prone to posterior circulation cerebral infarction.Basilar artery tortuosity is associated with vertebral artery dominance and moderate to severe carotid artery stenosis.