椎动脉优势与脑血管疾

发布时间：2018-10-12 12:50

【摘要】：目的探讨椎动脉优势(VAD)与面肌痉挛、三叉神经痛及脑血管疾病的相关性。方法收集在辽宁省人民医院神经科就诊并同时行头部MRI和MRA检查的后循环梗死、单纯头晕、突发性眩晕伴平衡障碍、偏头痛、面肌痉挛、三叉神经痛患者。根据有无VAD分为椎动脉优势组和非椎动脉优势组。收集患者的一般资料,记录疾病的发生率;记录后循环梗死的发生率、发生位置;分析VAD与基底动脉弯曲发生率及弯曲方向的关系;Pearson检验分析椎动脉直径差异与三叉神经痛患者的症状评分、基底动脉弯曲长度(BL)的相关性。结果本研究共纳入413例患者,VAD的发生率为52.3%;优势组中后循环梗死患者105例(105/413,25.42%),突发性眩晕伴平衡障碍患者39例(39/413,9.44%)、面肌痉挛患者12例(12/413,2.91%)、三叉神经痛患者11例(11/413,2.66%),与非优势组相比具有统计学差异(P0.05);在199例后循环梗死患者中,优势组梗死主要发生在小脑后下动脉供血区(PICA)(27/199,13.57%)和基底动脉供血区(BA)(45/199,22.61%)。PICA区梗死发生在VAD对侧的比例(20/105,19.05%)高于同侧(7/105,6.67%),BA区梗死主要发生在椎动脉优势同侧,其差异均具有统计学意义(P0.05);优势组中有117例存在基底动脉弯曲,明显高于非优势组(P0.05),143例左侧VAD患者中,有92例患者椎动脉向右侧弯曲;73例右侧优势患者中有20例患者基底动脉向左侧弯曲。椎动脉直径差异与三叉神经痛患者的症状评分呈正相关(r=0.336,P=0.001),与基底动脉弯曲长度呈正相关(r=0.432,P=0.004)。结论椎动脉优势人群后循环梗死、三叉神经痛、面肌痉挛的发生率较非优势人群高;椎动脉优势合并后循环梗死中以PICA和BA支配区多见;椎动脉优势患者基底动脉弯曲发生概率高,其弯曲方向与椎动脉优势方向相反;椎动脉直径差异越大,基底动脉弯曲长度越长,三叉神经痛患者的症状评分越高。
[Abstract]:Objective to investigate the relationship between superior (VAD) of vertebral artery and hemifacial spasm, trigeminal neuralgia and cerebrovascular diseases. Methods patients with posterior circulation infarction, simple dizziness, sudden vertigo with balance disorder, migraine, hemifacial spasm and trigeminal neuralgia were collected from neurology department of Liaoning Provincial people's Hospital. The patients were divided into vertebral artery dominant group and non-vertebral artery dominant group according to the presence or absence of VAD. The general data of the patients were collected to record the incidence of disease, the incidence and location of post-circulatory infarction. The relationship between VAD and the incidence and direction of basilar artery curvature was analyzed, and the correlation between the diameter difference of vertebral artery and the symptom score of patients with trigeminal neuralgia and the length of (BL) of basilar artery bending was analyzed by Pearson test. Results the incidence of VAD was 52.3%, 105 cases (105 / 41325.42%) of posterior circulation infarction, 39 cases (39 / 4139.44%) of sudden vertigo with balance disorder, 12 cases (12 / 4132.91%) of hemifacial spasm, 11 cases (114132.66%) of trigeminal neuralgia, and 39 cases (39 / 4139.44%) of sudden vertigo with balance disorder, 11 cases (114132.66%) of trigeminal neuralgia. In 199 patients with posterior circulatory infarction, there were significant differences between the potential group and the control group (P0.05). In the dominant group, the incidence of infarction in the posterior inferior cerebellar artery (PICA) (27 / 19913.57%) and basilar artery (BA) (45 / 19922.61%) in the contralateral side of VAD (20 / 105 卤19.05%) was significantly higher than that in the ipsilateral (7 / 1056.67%). The difference was statistically significant (P0.05), there were 117 cases of basilar artery curvature in the dominant group, which was significantly higher than that in the non-dominant group (P0.05). There were 92 cases of vertebral artery bending to the right and 20 of 73 cases of right dominant patients to the left side of the basilar artery. The difference of vertebral artery diameter was positively correlated with the symptom score of patients with trigeminal neuralgia (r = 0.336), and with the length of basilar artery bending (r = 0.432P ~ (0.004). Conclusion the incidence of posterior circulation infarction, trigeminal neuralgia and hemifacial spasm in the dominant population of vertebral artery is higher than that in the non-dominant group. The higher the diameter of vertebral artery, the longer the length of curvature of basilar artery, and the higher the score of symptoms in patients with trigeminal neuralgia.
【作者单位】：辽宁省人民医院神经内科;
【基金】：沈阳市科技计划项目(F14-158-9-07)
【分类号】：R743.3;R745.1

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