血管源性眩晕患者基于脑血管造影结果的危险因素分析

目的 分析血管源性眩晕患者脑血管造影(digital subtraction angiography,DSA)结果及相关危险因素，提高眩晕患者血管因素的认识。 方法 选择2017年3月—2018年10月在西安交通大学第二附属医院神经内科住院并行脑DSA的血管源性眩晕患者148例，分为椎基底动脉延长扩张症(vertebrobasilar dolichoectasia，VBD)组(42例)及非VBD组(106例)，分析血管源性眩晕患者的危险因素及与VBD之间的关系。 结果 148例患者平均年龄(59.43±13.02)岁，其中男性78例(52.7%)，基底动脉狭窄者(>50%)18例(12.2%)，VBD者42例(28.4%)。性别、高血压及椎动脉优势在VBD组及非VBD组间比较，差异有统计学意义(均P＜0.05)，糖尿病、高脂血症、冠心病、高同型半胱氨酸血症、高尿酸血症、吸烟、饮酒、眩晕病史及椎基底动脉狭窄在2组间比较差异无统计学意义(均P＞0.05)。Logistic回归分析显示椎动脉优势是VBD的独立危险因素(OR=4.326,P=0.001)。VBD组眩晕残障程度评分量表(DHI)评分为(81.14±9.42)分，非VBD组DHI评分为(69.25±8.57)分，2组比较差异有统计学意义(t=7.253,P<0.001)。 结论 随着影像技术的不断发展和对疾病认识的不断深入，VBD不再是一种少见的血管病变，其可能与血管源性眩晕的发生密切相关。眩晕合并VBD的患者眩晕程度更重，残障程度更高。椎动脉优势可能是VBD的独立危险因素。 

Risk factors analysis based on cerebral DSA results in vascular vertigo patients

Objective To analyze the results of cerebral DSA and related risk factors in patients with vascular vertigo, and to improve the understanding of vascular factors in patients. Methods A total of 148 vascular vertigo patients who were hospitalized in Neurology Department of the Second Affiliated Hospital of Xi' an Jiaotong University with cerebral DSA from March 2017 to October 2018, were selected and divided into vertebrobasilar dolichoectasia (VBD) group (n=42) and non-VBD group (n=106). The risk factors and relationship with VBD in patients with vascular vertigo were analyzed. Results The average age of 148 patients was (59.43±13.02) years, 78 (52.7%) were male, 18 (12.2%) were basilar artery stenosis (>50%) and 42 (28.4%) were VBD. There were significant differences in male, hypertension and vertebral artery dominance between VBD and non-VBD groups (all P<0.05), but there was no significant difference in diabetes, hyperlipidemia, coronary heart disease, hyperhomocysteinemia, hyperuricemia, smoking, drinking, vertigo history and vertebrobasilar artery stenosis between the two groups (all P>0.05). Logistic regression analysis showed that vertebral artery dominance was an independent risk factor for the VBD(OR=4.326,P=0.001). The DHI scores in VBD group was (81.14±9.42) and that in non-VBD group was (69.25±8.57, t=7.253,P<0.001). Conclusion With the continuous development of imaging technology and the deep understanding of disease, VBD is no longer a rare vascular disease, which may closely relate to the occurrence of vascular vertigo. Vertigo patients with VBD had more severe vertigo and higher disability. Vertebral artery dominance is an independent risk factor for the VBD.