锁骨下动脉盗血的临床特点分析

发布时间：2018-06-24 23:53

本文选题：锁骨下动脉盗血 + 动脉狭窄　；参考：《新疆医科大学》2014年硕士论文

【摘要】：目的：探讨锁骨下动脉盗血(subclavian steel syndrome, SSS)的危险因素、临床特点、诊断及脑血管造影的特点等。方法：回顾性分析2010年4月至2013年7月在新疆医科大学一附属医院就诊诊断为锁骨下动脉盗血并行TCD和脑血管造影检查的患者41例为观察组；选取同期住院排除锁骨下动脉盗血并行TCD及脑血管造影检查的患者82例。收集两组患者的吸烟史、高血压病史、糖尿病病史、脑梗死或TIA史、临床表现、辅助检查结果等临床资料,从而总结出锁骨下动脉盗血的临床特点。结果：(1)锁骨下动脉盗血组空腹血糖(FG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)、甘油三酯(TG)、吸烟、高血压、糖尿病、脑梗死或TIA与对照组比较具有显著性差异(均P0.05)。二元Logistic回归模型分析显示：高血压(OR=5.795)、糖尿病(OR=4.528)、吸烟(OR=2.135)、脑梗死或TIA(OR=2.129)、LDL-C(OR=2.009)、 TC(OR=2.091)、TG(OR1.969)。(2)左侧多于右侧,左：右比例为3：1,男女之间无显著性差异。(3)70.73%的患者合并有多支血管的病变,男女之间无明显差别。(4)临床表现为单纯后循环缺血症状9例,单纯上肢缺血症状13例,后循环缺血并上肢缺血症状11例,无任何临床表现8例。结论：锁骨下动脉盗血独立相关的危险因素依次是高血压、糖尿病、吸烟、脑梗死或TIA、LDL-C、TC、TG;大多数存在脑血管病的危险因素,而动脉粥样硬化是锁骨下动脉盗血的主要致病因素；其多发于左侧,而且男女之间无明显差异,常合并多支血管病变；锁骨下动脉盗血并非罕见,相当部分患者无明显的临床症状而被误诊或漏诊,其临床症状与侧枝循环有关；TCD是锁骨下动脉盗血的早期筛查的首选方法,而DSA检查是诊断锁骨下动脉盗血的金标准。
[Abstract]:Objective: to investigate the risk factors, clinical features, diagnosis and cerebral angiography of subclavian artery steal blood (subclavian steel syndrome,). Methods: from April 2010 to July 2013, 41 patients who were diagnosed as subclavian artery theft and TCD and cerebral angiography in a affiliated hospital of Xinjiang Medical University were analyzed retrospectively. 82 patients with subclavian artery steal and TCD and cerebrovascular angiography were selected in the same period. The history of smoking, hypertension, diabetes, cerebral infarction or TIA, clinical manifestations and auxiliary examination results were collected to summarize the clinical characteristics of subclavian artery steal blood. Results: (1) fasting blood glucose (FG), total cholesterol (TC), low density lipoprotein (LDL-C), triglyceride (TG), smoking, hypertension, diabetes, cerebral infarction or TIA in the subclavian artery steal group were significantly different from those in the control group (P0.05). The results of binary logistic regression analysis showed that hypertension (OR 5.795), diabetes mellitus (OR4.528), smoking (OR2.135), cerebral infarction or TIA (OR2.129) LDL-C (OR2.009), TC (OR2.091) TG (OR 1.969). (2) were more in left than right (OR 1.969). (2), the ratio of left to right was 31. There was no significant difference between male and female. There was no significant difference between male and female. (4) the clinical manifestations were simple posterior circulation ischemia in 9 cases, simple upper limb ischemia in 13 cases, posterior circulation ischemia with upper limb ischemia in 11 cases, and no clinical manifestations in 8 cases. Conclusion: the independent risk factors associated with subclavian artery theft are hypertension, diabetes, smoking, cerebral infarction or TIA-LDL-CfT TG.The majority of the risk factors are cerebrovascular diseases, and atherosclerosis is the main risk factor of subclavian artery theft. The subclavian artery steal blood is not rare, and most of the patients are misdiagnosed or missed diagnosis without obvious clinical symptoms, their clinical symptoms are related to collateral circulation. TCD is the first choice for early screening of subclavian artery theft, and DSA is the gold standard for diagnosis of subclavian artery theft.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3

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