椎基底动脉延长迂曲症患者临床特征及并发急性脑梗死相关危险因素分析

发布时间：2018-05-27 03:24

本文选题：椎基底动脉延长迂曲 + 脑梗死　；参考：《华中科技大学学报(医学版)》2017年05期

【摘要】：目的研究椎基底动脉延长迂曲症(vertebrobasilar dolichoectasia,VBD)的临床表现及影像学特点,并探讨影响VBD患者发生急性脑梗死的相关危险因素。方法收集2012年8月~2017年6月在武汉同济医院住院治疗,采用数字减影血管造影(digital subtraction angiography,DSA)确诊的VBD患者21例。对其临床表现、影像学检查结果进行回顾性分析,并采用Logistics回归分析探讨影响VBD患者发生急性脑梗死的相关危险因素。结果 21例患者中首发症状为脑梗死者15例,脑干或颅神经压迫4例,脑出血2例。对其中13例急性脑梗死患者进行病灶定位分析发现,病灶位于前循环者为4例、后循环者9例。临床合并吸烟、高血压以及较高D-D二聚体水平的VBD患者更容易发生急性脑梗死。结论对临床表现为后循环梗死的患者进行头颅影像学检查(如DSA)可以增加VBD的检出率,D-D二聚体升高为VBD患者发生急性脑梗死的独立危险因素。
[Abstract]:Objective to study the clinical and imaging features of vertebrobasilar dolichoectasia (VBDD) in patients with vertebrobasilar artery lengthening (VBA) and to explore the risk factors affecting the occurrence of acute cerebral infarction (ACI) in patients with VBD. Methods from August 2012 to June 2017, 21 patients with VBD diagnosed by digital subtraction angiography (DSA) in Tongji Hospital of Wuhan were collected. The clinical manifestations and imaging findings were analyzed retrospectively and the risk factors of acute cerebral infarction in patients with VBD were analyzed by Logistics regression analysis. Results among 21 patients, the initial symptoms were cerebral infarction in 15 cases, brain stem or cranial nerve compression in 4 cases, and cerebral hemorrhage in 2 cases. Among the 13 patients with acute cerebral infarction, 4 were located in anterior circulation and 9 in posterior circulation. VBD patients with smoking, hypertension and high D-D dimer levels were more likely to develop acute cerebral infarction. Conclusion cranial imaging examination (such as DSAs) in patients with posterior circulation infarction can increase the detection rate of VBD. D-D dimer is an independent risk factor for acute cerebral infarction in patients with VBD.
【作者单位】：华中科技大学同济医学院附属同济医院神经内科;
【基金】：国家自然科学基金资助项目(No.81301000)
【分类号】：R743.33

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