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目的探讨缺血性脑血管病患者脑动脉粥样硬化性狭窄闭塞的分布特点,分析并比较颅内、外动脉粥样硬化性狭窄的危险因素。方法对206例连续行主动脉弓及全脑血管造影检查的缺血性脑血管病患者的临床与血管造影资料进行分析,比较不同动脉病变类型患者间的危险因素的差异。结果 206例患者中,131例存在脑动脉狭窄或闭塞。脑动脉狭窄的好发部位主要为颈内动脉起始部和椎动脉起始部,颅外动脉病变(EAD)的发生率为71.0%,颅内动脉病变(IAD)的发生率为67.9%。青年患者大部分为单纯IAD,主要累及大脑中动脉(MCA);而中年及老年患者以颅内外病变并存比例最高,病变最好发于颈内动脉起始部。吸烟对于颅内、外动脉狭窄的影响较大,血脂异常、同型半胱氨酸血症对于颅内动脉狭窄的影响较大,高龄、高血压、冠心病和糖尿病对颅外动脉狭窄的影响较大。结论颅外动脉粥样硬化性狭窄闭塞病变的发生率高于颅内。不同动脉粥样硬化性病变类型患者的危险因素有所不同。
Objective To investigate the distribution of cerebral atherosclerosis occlusion in patients with ischemic cerebrovascular disease and to analyze and compare the risk factors of intracranial and external atherosclerotic stenosis. Methods The clinical and angiographic data of 206 consecutive patients with ischemic cerebrovascular disease undergoing aortic arch and cerebral angiography were analyzed to compare the risk factors among patients with different arterial disease types. Results Of the 206 patients, 131 had cerebral stenosis or occlusion. The predominant sites of cerebral stenosis were mainly the beginning of internal carotid artery and the beginning of vertebral artery. The incidence of extracranial arterial disease (EAD) was 71.0% and the incidence of intracranial artery disease (IAD) was 67.9%. The majority of young patients with simple IAD, mainly involving the middle cerebral artery (MCA); while middle-aged and elderly patients with the highest proportion of intracranial lesions coexist, lesions occur in the beginning of the internal carotid artery. Smoking has a greater impact on intracranial and external arterial stenosis, dyslipidemia, homocysteine have a greater impact on intracranial artery stenosis, elderly, hypertension, coronary heart disease and diabetes than on extracranial artery stenosis Big. Conclusion The incidence of extracranial atherosclerotic occlusive lesions is higher than intracranial. There are different risk factors for different types of atherosclerotic lesions.