短暂性脑缺血发作与颅内-外动脉狭窄的关系

目的 探讨短暂性脑缺血发作（TIA）与颅内-外动脉狭窄的关系。方法 回顾性分析200例行全脑血管造影TIA患者的临床资料。将所有患者按发病时的临床表现，分为颈动脉系统TIA组（CA—TIA组，152例）与椎-基底动脉系统TIA组（VB-TIA组，48例）；按不同发作频率分为：频发TIA组（123例）与非频发TIA组（77例）；按不同年龄段分为：〈50岁组（63例）、50～70岁组（112例）和〉70岁组（25例）。对存在动脉狭窄的患者计算动脉狭窄率，比较各组患者颅内-外动脉狭窄的分布情况，比较不同发作频率间和各年龄段间患者颅内-外血管严重狭窄及闭塞的发生情况。结果 ①本研究共175例患者存在颅内-外动脉狭窄，占87．5％（175／200）。颅外动脉狭窄为173例，以颈内动脉颅外段最多，占53．2％（92／173），而颅内动脉狭窄则以大脑中动脉最多，占39．3％（95／242）。颅内、颅外狭窄动脉比约为1．4：1（242／173）。②CA-TIA组单纯颅内动脉狭窄者多于VB-TIA组（P=0．001），而VB-TIA组单纯颅外动脉狭窄者多于CA—TIA组（P=0．006）。但二者间颅内-外动脉多发狭窄者差异无统计学意义（P=0．716）；③频发TIA组颅内-外血管重度狭窄及闭塞的发生率高于非频发组（P〈0．001）④200例TIA患者以50～70岁居多，且重度狭窄及闭塞发生率随年龄增长而呈升高的趋势，但差异无统计学意义（P〉0．05）。结论 颅内-外动脉狭窄是发生TIA的重要因素。对于高危人群，尤其是既往有频发TIA史的高龄患者应及早行相关检查，以明确是否存在颅内-外动脉狭窄及严重程度。

Relationship between transient ischemic attack and intra-and extracranial artery stenosis

Objective To investigate the relationship between transient ischemic attack （TIA） and intra- and extracranial arterial stenosis. Methods The clinical data from 200 patients with TIA who had cerebral angiography were analyzed retrospectively. All the patients were divided into carotid artery system TIA （CA-TIA, n = 152） and vertebro-basilar artery system TIA （VB-TIA, n =48） groups according to the clinical manifestation at the onset of the disease. They were divided into frequent TIA （ n = 123 ） and non frequent TIA （n = 77） groups according to the different attack frequencies ; and they also divided into 〈 50 years （ n = 63 ）, 50 to 70 years （ n = 112） and 〉 70 years （ n = 65 ） age groups. The percentage of arterial stenosis was calculated in patients with arterial stenosis. The distribution of intra- and extracranial arterial stenosis of the patients in all groups, between the different attack frequencies, and the occurrence of severe stenosis and occlusion of intra- and extracranial arteries at different age stages were compared. Results （1）A total of 175 patients （87.5%, 175/200） had intra- and extracranial arterial stenosis in this study. Extracranial artery stenosis were most common in the extracranial seaments of internal carotid artery （53.2%, 92/173）, and the middle cerebral arteries were most common in the intracranial counterparts （39.3% , 95/242）. The ratio was about 1.4：1 （242/173） between intracranial and extracranial stenotic arteries. （2）The patients with intracranial arterial stenosis only in the CA-TIA group were more than those in the VB-TIA group （P =0. 001 ）, while the patients with extracranial arterial stenosis only in the VB-TIA group were more than those in the CA-TIA group （ P = 0.006）. However, there were no significant difference between them in patients with multiple intra- and extracranial arterial stenosis （P =0.716）. （3）The incidence of the severe intra- and extracranial arterial stenosis or occlusion in t