脑桥梗死部位与椎基底动脉狭窄或闭塞的关系

目的 探讨脑桥梗死部位与椎基底动脉狭窄或闭塞之间的关系.方法 连续入选2005年2月至2007年9月收住北京宣武医院神经内科的新发脑桥部梗死患者139例,所有病例均行头部MRI以及全脑血管造影检查,排除有可疑心源性栓子来源的患者.将病例分为A(旁中央动脉组)、B(短旋动脉组)、C(长旋动脉组)、D(混合组)4组,并对各组进行与椎动脉、基底动脉狭窄或闭塞以及无血管病变的相关性研究.结果 139例患者中A、B、C、D组各占78(56.1%)、3(2.2%)、7(5.0%)、51(36.7%)例.左或右侧椎动脉闭塞者56例(40.3%),左或右椎动脉狭窄者60例(43.2%),基底动脉闭塞者14例(10.1%),基底动脉狭窄者14例(10.1%),无后循环血管改变者16例(11.5%).A组与椎动脉闭塞、基底动脉闭塞及无血管病变者相关,x2值分别为3.945、6.824、4.485,P值分别为0.043、0.021、O.041.D组与基底动脉闭塞相关,x2值为10.952,P值为0.006.对以上两者进行Logistic回归分析,发现A组与椎动脉闭塞更相关(OR值为2.261),D组与基底动脉闭塞更相关(OR值为15.750).结论 脑桥不同部位的梗死与椎基底动脉的狭窄或闭塞关系密切,提示临床医生在遇到相关病例时,应提高警惕,及时做血管检查.

Abstract：

Objective To investigate the correlation between stenosis or occlusion of vertebralbasilar artery and the location of infarctions in pontine. Methods All 139 patients with acute pontine infarction who were admitted to the Department of Neurology,Xuanwu Hospital,Beijing,during February,2005 and September,2007 were studied. All patients received the examinations of head MRI and digital subtraction angiography (DSA). Patients with possible cardiac embolism were excluded from the study. All the cases were then divided into four groups: A( paracentral artery group); B (short rotary artery group); C (long rotary artery group) and D (combined group). Results In all 139 cases,78 cases (56. 1% ) were in A group,3 (2. 2% ) in B group,7 (5.0%) in C group and 51 (36.7%) in D group. Fifty-six cases (40. 3% ) have occlusion in vertebral artery,60 cases (43.2%) have stenosis of vertebral artery. Cases having stenosis or occlusion in basilar artery are 14 cases (10. 1% ) each. Sixteen cases (11.5%) have unimpaired vertebral-basilar artery. A group is related to occlusion of vertebral artery and basilar artery and unimpaired artery ( x2 =3. 945,6. 824,4. 485 ,P = 0. 043,0. 021,0. 041 respectively). D group is related to occlusion of basilar artery ( x2 = 10. 952,P = 0. 006). Logistic binary analysis found that A group is more related with occlusion of vertebral artery ( OR = 2. 261 ),while D group is more related to occlusion of basilar artery ( OR = 15. 750). Conclusions There is a significant correlation between stenosis or occlusion of vertebral-basilar artery and the locations of infarctions in pontine. The physicians are suggested to perform the examinations on cerebral vessels such as brain MRI or DSA in patients with infarctions in pontine.

Correlation between stenosis or occlusion of vertebral-basilar artery and the location of infarctions in pontine

Objective To investigate the correlation between stenosis or occlusion of vertebralbasilar artery and the location of infarctions in pontine. Methods All 139 patients with acute pontine infarction who were admitted to the Department of Neurology,Xuanwu Hospital,Beijing,during February,2005 and September,2007 were studied. All patients received the examinations of head MRI and digital subtraction angiography (DSA). Patients with possible cardiac embolism were excluded from the study. All the cases were then divided into four groups: A( paracentral artery group); B (short rotary artery group); C (long rotary artery group) and D (combined group). Results In all 139 cases,78 cases (56. 1% ) were in A group,3 (2. 2% ) in B group,7 (5.0%) in C group and 51 (36.7%) in D group. Fifty-six cases (40. 3% ) have occlusion in vertebral artery,60 cases (43.2%) have stenosis of vertebral artery. Cases having stenosis or occlusion in basilar artery are 14 cases (10. 1% ) each. Sixteen cases (11.5%) have unimpaired vertebral-basilar artery. A group is related to occlusion of vertebral artery and basilar artery and unimpaired artery ( x2 =3. 945,6. 824,4. 485 ,P = 0. 043,0. 021,0. 041 respectively). D group is related to occlusion of basilar artery ( x2 = 10. 952,P = 0. 006). Logistic binary analysis found that A group is more related with occlusion of vertebral artery ( OR = 2. 261 ),while D group is more related to occlusion of basilar artery ( OR = 15. 750). Conclusions There is a significant correlation between stenosis or occlusion of vertebral-basilar artery and the locations of infarctions in pontine. The physicians are suggested to perform the examinations on cerebral vessels such as brain MRI or DSA in patients with infarctions in pontine.