老年后循环缺血患者单侧椎动脉优势现象研究

目的探讨单侧椎动脉优势现象在老年后循环缺血(posterior circulation ischemia,PCI)发病中的意义。方法选择PCI及老年前循环脑卒中患者229例,根据诊断分为老年PCI组(老年组)91例,中年PCI组(中年组)68例,老年前循环脑卒中患者(前循环组)70例。通过全脑数字减影血管造影术对比检测一侧椎动脉优势现象分布差异,分析椎动脉优势与PCI的相互关联,及二者的优势比。结果老年组椎动脉优势52例(57.1%),中年组26例(38.2%),前循环组22例(31.4%),老年组椎动脉优势现象发生率明显高于中年组和前循环组,差异有统计学意义(P<0.05,P<0.01)。老年组有单侧椎动脉优势的危险较中年组和前循环组明显增高(OR=2.154,95%CI:1.134～4.091;OR=2.909,95%CI:1.513～5.592)。结论单侧椎动脉优势现象是老年PCI常见的血管变异,与老年PCI间存在明显关联。

Lateral vertebral artery dominance in elderly patients with posterior circulation ischemia

Objective To study the role of lateral vertebral artery(VA) dominance in pathogenesis of posterior circulation ischemia(PCI) in elderly patients.Methods Two hundred and twenty-nine consecutive patients with PCI and anterior circulation stroke were divided into old age PCI group(old age group,n=91),middle age PCI group(middle age group,n=68) and anterior circulation stroke group(n=70) according to their diagnosis.Distribution of lateral VA dominance was deteced by digital subtraction angiography.Correlation between lateral VA dominance and PCI and their odds ratio(OR) were analyzed.Results The lateral VA dominance was found in 52 patients(57.1%) of old age group,26 patients(38.2%) of middle age group,and 22 patients(31.4%) of anterior circulation stroke group.The incidence of VA dominance was significantly higher in old age group than in middle age group and anterior circulation group(P<0.05,P<0.01).The risk of lateral VA was significantly higher in old age group than in middle age group and anterior circulation stroke group(OR=2.154,95%CI:1.134-4.091;OR=2.909,95%CI:1.513-5.592).Conclusion Lateral VA dominance is a common vascular variant in elderly PCI patients,which is closely related with PCI in elderly patients.