椎基底动脉延长扩张症患者的临床特点

 目的 研究椎基底动脉延长扩张症(VBD)患者的临床特点。方法 连续收集2008年10月至2012年2月确诊的VBD患者27例设为VBD组,并设置同期临床表现相似的非VBD脑血管病患者81例为对照组,分析VBD的危险因素、脑血流动力学特点,并总结神经影像学和临床表现特征。 结果 (1)两组患者间在血脂水平及合并基础心脑血管疾病上差异有统计学意义(P<0.05);(2)VBD患者的脑血流动力学特征主要表现为椎基底动脉收缩期峰值血流速度减慢,收缩/舒张比值降低,VBD组和对照组的峰值平均血流速度(-27±9比-40±15)、搏动指数(0.38±0.15比0.78±0.19)、阻力指数(0.48±0.23比0.88±0.18)比较差异均有统计学意义(P值分别为0.036、0.032、0.032);(3)VBD患者临床主要表现为脑梗死,以后循环微小梗死为主,其次表现为脑出血、对周边组织的压迫症状和体征、脑积水等,多合并出现,经MRI检查多可确诊。结论 VBD患者具有相对特异的临床特征,MRI 检查为首选。

The clinical characteristics of patients with vertebrobasilar dolichoectasia

Objective To explore the clinical features of patients with vertebrobasilar dolichoectasia(VBD).Methods Patients diagnosed with posterior circulation ischemia in our hospital from October 2008 to January 2012 were consecutively collected and were divided into the VBD group and the non-VBD(NVBD) group. Clinical manifestations, risk factors, hemodynamic parameters and neuroimaging features were collected. Results (1) Statistical difference was observed in dyslipidemia, hypertension and the history of diabetes in the two groups (P<0.05). (2) The cerebral hemodynamic features of the VBD patients were as the following: decreased peak systolic velocity of vertebral artery and basilar artery and decreased systolic/diastolic ratio. Statistical difference was showed in the average peak flow velocity(Vm), pulsatility index(PI) and resistance index(RI) (P=0.036, 0.032, 0.032, respectively). (3) The main clinical manifestations of VBD were ischemic cerebrovascular disease, hemorrhagic cerebrovascular disease, oppression, brain damage symptoms and hydrocephalus. (4) The diagnosis in most of the VBD patients was confirmed by neural imaging and MRI was the first choice. Conclusion The VBD patients have relative unique clinical features. MRI should be the first choice for neuroimaging.