脑梗死患者颅内和颈部动脉狭窄的分布及特点

目的：探讨脑梗死（CI）患者颅内和颈部动脉狭窄的分布及特点.方法：采用超高场强磁共振血管造影（3.0TMRA）测定186例CI患者颅内和颈部动脉,并与121例轻度头昏患者对照.结果：186例CI患者有动脉狭窄164例（88.17%）.狭窄动脉分布： ①颅内动脉狭窄率为83.54 %,颈部动脉狭窄率为51.83%.②前循环单一动脉狭窄60/164例（36.59%）,其中颅内50例,颈部10例;后循环动脉狭窄38/164例（23.17%）,其中颅内21例,颈部17例. ③合并前、后循环颅内和颈部两条以上动脉狭窄66/164例（40.24%）.46～60岁组患者以前循环动脉狭窄为主（54.05%）,其中主要为颅内大脑中动脉;〉60岁组前循环动脉狭窄比例相对有所减少（30.08%）,而后循环动脉狭窄（26.02%）和多发动脉狭窄（43.90%）明显增加（P〈0.05）.结论：46～60岁CI患者动脉狭窄以前循环颅内动脉为主,〉60岁CI患者后循环动脉狭窄和累及前后循环颅内和颈部动脉的多发动脉狭窄相对明显增加.

Distribution of Intracranial Artery Stenosis and Carotid Artery Stenosis in Patients with Cerebral Infarction

Aim： To explore the characteristics of distribution of intracranial artery stenosis and carotid artery stenosis in patients with cerebral infarction. Methods： 3.0T MRA was used to assess intracranial artery stenosis and carotid artery stenosis in 186 patients with cerebral infarction and 121controls. Results： The 164 subjects with intracranial artery stenosis or carotid artery stenosis were found in 186 patients with cerebral infarction, the intracranial artery stenosis was 83.54%, the carotid artery stenosis was 51.83%, among them, there were 60 subjects with simplex anterior circulation artery stenosis（60/164, 36.59%） including 50 intracranial artery stenosis and 10 carotid artery stenosis, 38 subjects with simplex posterior circulation artery stenosis（38/164, 23.71%） including 21 intracranial artery stenosis and 17 carotid artery stenosis, and 66 subjects with complex artery stenosis coexisting in intracranial artery and carotid artery（66/164, 40.24%）. In the patients aged 46 to 60 years, the proportion of simplex anterior circulation artery stenosis was high（54.05%）, and middle cerebral artery was affected frequently. In contrast, the proportion of simplex anterior circulation artery stenosis was lower（30.08%）, and the proportions of simplex posterior circulation artery stenosis（26.02%） and complex artery stenosis（43.90%） was higher respectively in the patients aged 60 years and over（P〈0.05）. Conclusion： In the patients aged 46 to 60 years, the prevalence of simplex anterior circulation artery stenosis was higher than that of other location. The prevalence of simplex posterior circulation artery stenosis and complex artery stenosis increased with the ages significantly.