摘要
目的探讨椎动脉发育不E（VAI-I）与前／后循环脑梗死，尤其是急性后循环脑梗死（APCCI）的关系。方法收集自2015年3月至2016年3月间因新发急性脑梗死于中国医科大学附属盛京医院神经内科住院的189例连续急性脑梗死患者资料进行回顾性分析。比较前循环脑梗死（ACI）与后循环脑梗死（PCI）患者一般临床特征；采用单纯头部MRA，单纯VA超声检查及头部MRA＋VA超声3种方式判断VAH发生情况：对APCCI伴VAH病例进行梗死部位分类并研究两侧椎动脉直径差与美国国立卫生研究院卒中量表fNIHSS）关系。结果（1）189例脑梗死患者中出现VAH32例（16．93％1，排除8例前后循环均梗死患者，将余下181例分为PCI组90例（49．72％），ACI组（对照组）91例（50．28％）。统计结果提示甘油三酯（TG）及VAH在2组患者间的差异具有统计学意义（氏0．05）。（2）在23例APCCI伴VAH患者中，脑干梗死9例（5例VAH在梗死同侧、3例对侧、1例双侧VAH），小脑梗死1例（同侧），丘脑梗死10例（4例同侧、6例对侧），枕叶梗死2例（1例同侧、1例对侧），小脑伴丘脑梗死1例（VAH在小脑梗死同侧、在丘脑梗死对侧）。（3）排除1例双侧VAH，在余下22例伴VAH的APCCI中，两侧VA直径差与NmSS评分呈显著正相关（r=0．560，P=0．000）。结论（1）头部MRA与VA超声联合测量VA直径为VAH的最佳评估标准；（2）TG及VAH为APCCI的危险因素；（3）APCCI伴VAH患者中，脑干、小脑梗死多在VAH同侧，丘脑梗死多在VAH对侧；（4）两侧VA直径差越大，患者预后越差。
Objective To explore the relationship of vertebral artery hypoplasia （VAH） with acute posterior circulation cerebral infarction （APCCI）. Methods One hundred and eighty-nine consecutive patients diagnosed as having acute cerebral infarction admitted to our hospital from March 2015 to March 2016 were enrolled in our study; retrospective analysis was performed on their clinical and radiographic data to compare the general clinical characteristics of patients with posterior circulation infarction （PCI） and anterior circulation infarction （ACI）. VAH was conformed by cranial magnetic resonance angiography （MRA）, vertebral artery ultrasound or cranial MRA＋vertebral artery Ultrasound. The infarction lesions in VAH patients with APCCI were typed; the correlation between vertebral artery diameter＇s differences and National Institute of Health stroke scale （NIHSS） scores in VAH patients with APCCI was illuminated. Results In 189 consecutive patients with acute cerebral infarction, 32 （16.93%） were with VAH; after exclusion of 8 with infarction in both anterior and posterior circulation, 90 （49.72%） were in PCI group while 91（50.28%） in the ACI group. Univariate analysis showed that statistical differences were noted between the two groups in triglyceride （TG） and VAH levels （P〈0.05）. In 23 patients with APCCI with VAH, brain stem infarction consisted of 9 patients （5 VAHs were ipsilateral to the infarction, 3 VAHs contralateral and one bi-VAH）, cerebellum infarction consisted of one patient （ipsilateral side）, thalamus infarction 10 patients （4 VAHs were ipsilateral to the infarction, and 6 VAHs contralateral）, occipital lobe infarction 2 patients （one ipsilateral and one contmlateral） and cerebellum with thalamus infarction one patient （the side of VAH was ipsilateral to the cerebellum and contralateral to the thalamus）. After excluding one patient with bi-VAH, in 22 patients with APCCI combined with VAH, significantly positive correlation between verteb
出处
《中华神经医学杂志》
CAS
CSCD
北大核心
2017年第1期22-27,共6页
Chinese Journal of Neuromedicine
关键词
椎动脉发育不良
脑梗死
后循环
Vertebral artery hypoplasia
Cerebralinfarction
Posterior circulation
