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椎-基底动脉迂曲对老年血管源性头晕/眩晕脑梗死的影响
Effects of vertebrobasilar artery tortuosity on vasogenic dizziness/vertigo-related cerebral infarction in the elderly
收稿日期:  
DOI:10.3969/j.issn.1673-9701.2024.19.010
关键词:  椎-基底动脉迂曲  血管源性头晕/眩晕  脑梗死  老年人
Key Words:
基金项目:山西省太原市“六个一批”科研项目(Y2022013)
作者单位
张冬萍 太原西山医院神经内科山西太原 030053 
王艳艳 太原西山医院神经内科山西太原 030053 
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摘要:目的 探讨椎-基底动脉迂曲与老年血管源性头晕/眩晕脑梗死的关系。方法 选取2022年1月至2023年10月太原西山医院神经内科住院的老年血管源性头晕/眩晕脑梗死患者160例,根据头颅磁共振血管成像检查是否存在椎-基底动脉异常将其分为迂曲组和非迂曲组,每组各80例。比较两组患者的一般临床资料、血管病危险因素、美国国立卫生研究院卒中量表扩展版(expanded-National Institutes of Health stroke scale,e-NIHSS)评分。迂曲组根据椎-基底动脉形态又分为单纯异常组和混合异常组,分析对相关脑梗死的影响程度。结果 迂曲组患者的高血压、椎动脉优势、吸烟史的比例和e-NIHSS评分均显著高于非迂曲组(P<0.05)。多因素Logistic回归分析结果显示,高血压病史、椎动脉优势、吸烟史均是伴有椎-基底动脉异常老年血管源性头晕/眩晕脑梗死患者的独立危险因素(P<0.05)。单纯异常组中54.3%为中重度脑卒中患者,混合异常组中58.8%为中重度脑卒中患者,两组比较差异无统计学意义(2=0.029,P=0.864)。结论 高血压病史、椎动脉优势、吸烟史是伴有椎-基底动脉迂曲的老年血管源性头晕/眩晕脑梗死的独立危险因素,此类患者神经功能缺损评分更高。
Abstract:Objective To investigate the relationship between vertebrobasilar artery tortuosity and vasogenic dizziness/ vertigo-related cerebral infarction in the elderly. Methods A total of 160 elderly patients with vasogenic dizziness/vertigo-related cerebral infarction admitted to the Department of Neurology of Taiyuan Xishan Hospital from January 2022 to October 2023 were selected. The patients were divided into tortuous group and non-tortuous group, 80 cases in each group, according to the presence of vertebrobasilar artery abnormality by magnetic resonance angiography. The general clinical data, vascular disease risk factors, and the expanded-National Institutes of Health stroke scale (e-NIHSS) score of two groups were compared. The tortuous group was divided into simple abnormality group and mixed abnormality group according to vertebrobasilar artery morphology, and the degree of influence on related cerebral infarction was analyzed. Results The proportion of hypertension, vertebral artery dominance, smoking history and e-NIHSS score in ortuous group were significantly higher than those in non-tortuous group (P<0.05). Multivariate Logistic regression analysis showed that history of hypertension, vertebral artery dominance, and smoking history were independent risk factors for elderly patients with vasogenic dizziness/vertigo-related cerebral infarction with vertebrobasilar artery abnormality (P<0.05). 54.3% of patients in simple abnormality group were moderate to severe stroke patients, and 58.8% of patients in mixed abnormality group were moderate to severe stroke patients, and there was no statistical significance between two groups (2=0.029, P=0.864). Conclusion History of hypertension, vertebral artery dominance, and smoking history were independent risk factors for vasogenic dizziness/vertigo-related cerebral infarction in elderly patients with vertebrobasilar artery tortuosity, and these patients had higher neurological deficit scores.
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