椎动脉优势与基底动脉弯曲的关系及其对脑梗死发生率的影响

目的探讨椎动脉优势与基底动脉弯曲的关系对两者连接处脑梗死发生的影响。方法选取在我院神经内科住院治疗符合本研究纳入标准的109例急性脑梗死患者。对患者的影像学资料、梗死灶情况、椎动脉优势以及基底动脉弯曲等情况进行分析。结果92．66％（101／109）的患者表现为一侧椎动脉直径大于另一侧。68．81％（75／109）的患者椎动脉优势位于左侧。74．31％（81／109）的患者有基底动脉弯曲。随着椎动脉直径差异级别的增高，患高血压痛、中重度基底动脉弯曲的比例显著增高，且右侧椎动脉直径显著减小（P〈0．05）。3级椎动脉直径差异的患者大多有高血压病（88．89％）以及中重度基底动脉弯曲（75．00％）。单因素分析显示，老年、患有高血压病以及椎动脉直径差异是中重度基底动脉弯曲的相关因素；多因素Logistic回归分析显示，椎动脉直径差异为中重度基底动脉弯曲的独立危险因素。结论中重度基底动脉弯曲的独立危险因素是椎动脉直径差异，两者的存在促进了相应部位脑梗死的发生。

Relationship Between the Vertebral Artery Dominance and Basilar Artery Curvature and its Influence on the Incidence of Cerebral Infarction.

Objective To investigate the relationship between vertebral artery dominance and basilar artery curvature and its influence on the incidence of cerebral infarction. Methods 109 patients with acute cerebral infarction patients in this study in- cluded standard were selected. The imaging information, infarcts, vertebral artery dominance and basilar artery curvature of the patients were analyzed. Results 92. 66% （101/109） patients showed unilateral vertebral artery diameter was longer than that of the other side. 68.81% （75/109） patients＇ vertebral artery dominance were located on the left side. 74. 31% （81/109） patients happened with basilar artery curvature. With the increase of the vertebral artery diameter difference, the rate of hypertension and severe basilar artery curvature were significantly increased, and the right vertebral artery diameter significantly decreased （P 〈 0. 05）. Most of the patients with level 3 vertebral artery diameter difference were hypertension （88.89%） and severe basilar ar- tery curvature （75.00%）. Univariate analysis showed that age, hypertension and vertebral artery diameter difference were the re- lated factors of severe basilar artery curvature. Logistic regression analysis showed that the vertebral artery diameter difference was the independent risk factor for severe basilar artery curvature. Conclusion The vertebral artery diameter difference is the inde- pendent risk factor of severe basilar artery curvature. The vertebral artery dominance and basilar artery curvature promote the oc- currence of cerebral infarction in the combination of the department.