颈动脉迂曲与前循环动脉瘤形成的相关性研究

目的 探讨颈动脉迂曲与前循环动脉瘤形成的相关性。方法 采用头颈部CTA检查测量2018年1-6月100例前循环动脉瘤住院患者与同期100例无颅内动脉瘤住院患者的颈总动脉（common carotid artery，CCA）迂曲指数（tortuosity index，TI）、颈内动脉（internal carotid artery，ICA）TI、颈动脉夹角（ICA角）等指标，来衡量颈动脉的迂曲程度。Pearson相关分析CCA TI、ICA TI、ICA角与一般危险因素的关系，使用单因素及多因素逐步Logistic回归分析颈动脉迂曲与前循环动脉瘤形成的关系。结果 前循环动脉瘤组高脂血症病史（43% vs 58%，P =0.034）、缺血性卒中病史（39% vs 58%，P =0.007）比例低于对照组，而C CA TI（1.409±0.135 vs 1.352±0.137，P =0.004）、I CA TI（1.592±0.186 vs 1.523±0.149，P =0.005）、ICA角（46.450°±6.465°vs 44.303°±6.409°，P =0.016）均高于对照组。前循环动脉瘤组CCA TI与冠心病病史正相关（r =0.220，P =0.027），ICA TI与男性正相关（r =0.244，P =0.025）。I CA TI（OR 4.694，95%CI 0.999～1.099，P =0.018）、I CA角（OR 1.052，95%CI1.389～23.308，P =0.039）是前循环动脉瘤的独立危险因素，而缺血性卒中史患者较少发生动脉瘤（OR 0.569，95%CI 0.313～1.017，P =0.045）。结论 颈内动脉迂曲程度与男性相关，颈总动脉迂曲程度与冠心病病史相关，颈动脉迂曲程度是前循环动脉瘤形成的独立危险因素,而缺血性卒中史患者较少发生动脉瘤。

Relationship between Carotid Tortuosity and Anterior Circulation Aneurysms

Objective To investigate the relationship between carotid tortuosity and anterior circulation
aneurysms.
Methods 100 inhospital patients with anterior circulation aneurysms and 100 inhospital patients
without aneurysms between January and June 2018 were selected. All these patients underwent the
head and neck CTA examination, and the tortuosity index (TI) of common carotid artery (CCA), TI
of internal carotid artery (ICA) and ICA angle were measured, which representing arterial tortuosity.
The correlation of CCA TI, ICA TI and ICA angle with general risk factors were analyzed,
univariate and multivariate logistic regression were used to analyze the relationship between carotid
artery tortuosity and the formation of anterior circulation aneurysms.
Results The rate of hyperlipidemia (43% vs 58%, P =0.034), history of ischemic stroke (39% vs 58%,
P =0.007) in aneurysm group were lower than that in control group, while CCA TI (1.409±0.135 vs
1.352±0.137, P =0.004), ICA TI (1.592±0.186 vs 1.523±0.149, P =0.005) and ICA angle (46.450°±6.465°
vs 44.303°±6.409°, P =0.016) were higher than that in control group. CCA TI was positively correlatedwith coronary heart disease history (r =0.220, P =0.027), and ICA TI was positively correlated with
male (r =0.244, P =0.025) in aneurysm group. ICA TI (OR 4.694, 95%CI 1.389-23.308, P =0.018)
and ICA angle (OR 1.052, 95%CI 0.999-1.099, P =0.039) were independent risk factors for anterior
circulation aneurysm, and the patients with history of ischemic stroke were less likely to have
aneurysm (OR 0.569, 95%CI 0.313-1.017, P =0.045).
Conclusions CCA TI was associated with the history of coronary heart disease, and ICA TI was
associated with men. The degree of carotid artery tortuosity was an independent risk factor for
anterior circulation aneurysm, and the patients with history of ischemic stroke were less likely to
have anterior circulation aneurysm.