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目的通过数字减影血管造影(DSA)检查,观察短暂性脑缺血发作(transient ischemic attacks,TIA)患者脑动脉狭窄的分布特征及侧支循环情况。观察并探讨TIA的危险因素。方法回顾分析60例全脑血管造影TIA患者脑动脉颅内段、颅外段病变分布情况及其危险因素。结果 60例TIA患者中,血管造影阳性50例(83.3%),阴性10例(16.7%)。颅外段狭窄明显多于颅内段狭窄,颅外段狭窄占64.0%,颅内段狭窄占36.0%;与无狭窄组比较,脑血管狭窄组吸烟、高血压患者检出率高(P<0.05,P<0.01),Logistic回归分析显示高血压病是脑血管狭窄的独立危险因素(OR=1.98,P=0.03)。结论 DSA对TIA与脑动脉病变能准确的评估,对明确TIA的病因有重要的临床价值,对治疗具有指导意义。脑血管狭窄是TIA发作的最常见病因;TIA患者的颅内血管狭窄发生率低于颅外血管;吸烟、高血压病是颅外血管狭窄的危险因素。
Objective To observe the distribution and collateral circulation of cerebral artery stenosis in patients with transient ischemic attacks (TIA) by digital subtraction angiography (DSA). To observe and explore the risk factors of TIA. Methods The distribution and risk factors of intracranial and extracranial lesions in 60 patients with cerebral angiography TIA were retrospectively analyzed. Results Of 60 TIA patients, angiography was positive in 50 cases (83.3%) and negative in 10 cases (16.7%). Extracranial stenosis was significantly more than intracranial stenosis, extracranial stenosis accounted for 64.0%, intracranial stenosis 36.0%; compared with non-stenosis group, cerebrovascular stenosis group smoking and high blood pressure detection rate (P < 0.05, P <0.01). Logistic regression analysis showed that hypertension was an independent risk factor for cerebrovascular stenosis (OR = 1.98, P = 0.03). Conclusion The accurate assessment of TIA and cerebral artery disease by DSA has important clinical value in identifying the cause of TIA and is of guiding significance for the treatment. Cerebrovascular stenosis is the most common cause of TIA; the incidence of intracranial vascular stenosis in TIA patients is lower than that in extracranial blood vessels; smoking and hypertension are risk factors for extracranial vascular stenosis.