Stanford A型主动脉夹层对颈动脉血流影响及与脑梗死发生相关性

发布时间：2018-08-25 10:40

【摘要】：目的分析Stanford A型主动脉夹层(AD)累及颈动脉时对血流的影响,为探讨A型主动脉夹层与脑梗死的相关性提供参考依据。方法连续收集急诊超声诊断并经CT血管造影术(CTA)确诊的41例急性Stanford A型主动脉夹层患者,分为夹层未累及颈动脉组(A组,n=20)和累及颈动脉组(B组,n=21),分析两组颈动脉频谱及血流量差异并比较脑梗死发生率及病死率。结果 Stanford A型AD患者头臂血管累及率高达51.20%。A、B两组间的颈动脉频谱形态和血流量间差异有统计学意义(P0.05),B组中频谱形态异常者明显高于A组(P0.05),双侧颈内动脉(ICA)和椎动脉(VA)血流量比较,B组明显低于A组(P0.05);比较两组间新发脑梗死发生率(20.00%vs 42.86%,P=0.115 9)、病死率(20.00%vs 38.10%,P=0.203 1)无统计学差异。结论 Stanford A型夹层头臂血管累及率高,虽然脑梗死发生率和病死率未显示明显差别,但累及颈动脉时频谱形态及入颅血流量明显受到影响,应及时对急性A型主动脉夹层患者颈动脉进行评估,为主动脉夹层患者脑梗死防治及改善预后提供重要依据。
[Abstract]:Objective To analyze the influence of Stanford type A aortic dissection (AD) on blood flow in patients with carotid artery involvement, and to provide reference for exploring the correlation between type A aortic dissection and cerebral infarction. The frequency spectrum and blood flow of carotid artery in group A (n=20) and group B (n=21) were analyzed and the incidence and mortality of cerebral infarction were compared. Compared with group A (P 0.05), the blood flow of bilateral internal carotid artery (ICA) and vertebral artery (VA) in group B was significantly lower than that in group A (P 0.05), and the incidence of new cerebral infarction (20.00% vs 42.86%, P = 0.1159) and mortality (20.00% vs 38.10%, P = 0.2031) were not significantly different between the two groups. The incidence and mortality of acute type A aortic dissection were not significantly different, but the frequency spectrum and blood flow were significantly affected when the carotid artery was involved.
【作者单位】：解放军第四军医大学西京医院超声医学科;
【基金】：国家自然科学基金(No.81301228) 陕西省国际合作项目(No.2015KW-049)
【分类号】：R445.1;R543.1;R743.3

【参考文献】