摘要
目的 探讨无症状、短暂性脑缺血(TIA)及同侧急性缺血性脑卒中(AIS)颈动脉蹼(CaW)患者的临床及影像学特征.方法 回顾性选择经CT血管造影(CTA)诊断为CaW的患者,按照CaW与TIA、AIS发生与否,分为无症状性CaW组、TIA CaW组、AIS CaW组,比较三组患者的临床及CTA CaW影像学特征.结果 76例CaW患者,共发现CaW 85个,其中无症状性CaW组26例、TIA CaW组22例、AIS CaW组19例、合并其他脑血管病9例.男59例,女17例.在临床特征卡方及方差分析比较,伴有糖尿病、高血压、吸烟、高密度脂蛋白水平改变,三组患者间差异均有统计学意义(P＜0.05).在高血压、吸烟组间分析中,无症状与TIA CaW组、AIS CaW组之间有统计学意义(P＜0.05),在糖尿病组间分析中,TIA CaW组与无症状、AIS CaW组之间有统计学意义(P＜0.05).在高密度脂蛋白水平比较组间方差分析中,无症状组与TIA CaW组、AIS CaW组之间有统计学意义(P＜0.05).在CaW影像特征包括轴位长度、斜矢状位长度、角度、狭窄程度单因素方差分析三组比较,仅狭窄程度有统计学意义(F=3.43,P＜0.05),其中无症状组与AIS CaW组之间有统计学意义(P＜0.05).年龄、性别、收缩压、舒张压、总胆固醇水平、甘油三脂水平、低密度脂蛋白水平、CaW(轴位长度、斜矢状位长度、角度)均无统计学意义(P＞0.05).结论 CaW以男性多见,在存在相关危险因素高血压、糖尿病、吸烟及高密度脂蛋白水平改变的CaW患者,其更易于发生TIA或者缺血性脑卒中事件.CaW形态结构所致的管腔狭窄亦与缺血性脑卒中有着密切关系.
Abstract
Objective To investigate the clinical and imaging features of carotid web(Caw)patients with asymptomat-ic,transient ischemic attack(TIA),ipsilateral acute ischemic stroke(AIS).Methods Patients diagnosed with carotid webs by CT angiography(CTA),which were retrospectively selected and divided into three groups(asymptomatic Caw group,TIA Caw group and ipsilateral AIS Caw group),according to the occurrence of acute ischemic change.Results A total of 76 Caw patients were diagnosed,including 26 asymptomatic Caw,22 TIA Caw,19 AIS Caw and 9 other cerebrovas-cular disease.There were 59 males and 17 females.There was a statistical significance in hypertension,smoking and high-density lipoprotein levels(asymptomatic Caw vs.TIA,asymptomatic Caw vs.AIS,P＜0.05).There was a statistical sig-nificance in diabetes(TIA vs.asymptomatic Caw,TIA vs.AIS,P＜0.05).In the comparison of three groups of carotid webs image features including axial length,oblique sagittal length,angle and stenosis,only stenosis had statistical signifi-cance(asymptomatic Caw vs.AIS,P＜0.05).Age,sex,systolic blood pressure,diastolic blood pressure,total cholesterol level,triglyceride level,low density lipoprotein level,carotid webs(axial length,oblique sagittal length,angle)had no statis-tical significance(P＞0.05).Conclusion Carotid web is more common in males.Carotid web patients with associated risk factors such as hypertension,diabetes,smoking and high-density lipoprotein levels may be more liable to the occurrence of TIA and AIS.Carotid stenosis caused by carotid webs,which is also closely related to AIS.
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