颈动脉迂曲与前循环动脉瘤形成的相关性研究

doi:10.3969/j.issn.1673-5765.2020.03.008

摘要/Abstract

摘要：

目的探讨颈动脉迂曲与前循环动脉瘤形成的相关性。方法采用头颈部CTA检查测量2018年1-6月100例前循环动脉瘤住院患者与同期100例无颅内动脉瘤住院患者的颈总动脉（common carotid artery，CCA）迂曲指数（tortuosity index，TI）、颈内动脉（internal carotid artery，ICA）TI、颈动脉夹角（ICA角）等指标，来衡量颈动脉的迂曲程度。Pearson相关分析CCA TI、ICA TI、ICA角与一般危险因素的关系，使用单因素及多因素逐步Logistic回归分析颈动脉迂曲与前循环动脉瘤形成的关系。结果前循环动脉瘤组高脂血症病史（43% vs 58%，P =0.034）、缺血性卒中病史（39% vs 58%， P =0.007）比例低于对照组，而C CA TI（1.409±0.135 vs 1.352±0.137，P =0.004）、I CA TI （1.592±0.186 vs 1.523±0.149，P =0.005）、ICA角（46.450°±6.465°vs 44.303°±6.409°，P =0.016）均高于对照组。前循环动脉瘤组CCA TI与冠心病病史正相关（r =0.220，P =0.027），ICA TI与男性正相关（r =0.244，P =0.025）。I CA TI（OR 4.694，95%CI 0.999～1.099，P =0.018）、I CA角（OR 1.052，95%CI 1.389～23.308，P =0.039）是前循环动脉瘤的独立危险因素，而缺血性卒中史患者较少发生动脉瘤（OR 0.569，95%CI 0.313～1.017，P =0.045）。结论颈内动脉迂曲程度与男性相关，颈总动脉迂曲程度与冠心病病史相关，颈动脉迂曲程度是前循环动脉瘤形成的独立危险因素,而缺血性卒中史患者较少发生动脉瘤。

文章导读： 通过病例的回顾性研究发现，颈动脉迂曲程度（ICA TI，ICA角）是前循环动脉瘤形成的独立危险因素，颈动脉严重迂曲在颅内动脉瘤中应给予重视。

关键词: 颈动脉迂曲; 迂曲指数; 前循环动脉瘤; 危险因素

Abstract:

Objective To investigate the relationship between carotid tortuosity and anterior circulation aneurysms. Methods 100 inhospital patients with anterior circulation aneurysms and 100 inhospital patients without aneurysms between January and June 2018 were selected. All these patients underwent the head and neck CTA examination, and the tortuosity index (TI) of common carotid artery (CCA), TI of internal carotid artery (ICA) and ICA angle were measured, which representing arterial tortuosity. The correlation of CCA TI, ICA TI and ICA angle with general risk factors were analyzed, univariate and multivariate logistic regression were used to analyze the relationship between carotid artery tortuosity and the formation of anterior circulation aneurysms. Results The rate of hyperlipidemia (43% vs 58%, P =0.034), history of ischemic stroke (39% vs 58%, P =0.007) in aneurysm group were lower than that in control group, while CCA TI (1.409±0.135 vs 1.352±0.137, P =0.004), ICA TI (1.592±0.186 vs 1.523±0.149, P =0.005) and ICA angle (46.450°±6.465° vs 44.303°±6.409°, P =0.016) were higher than that in control group. CCA TI was positively correlated with coronary heart disease history (r =0.220, P =0.027), and ICA TI was positively correlated with male (r =0.244, P =0.025) in aneurysm group. ICA TI (OR 4.694, 95%CI 1.389-23.308, P =0.018) and ICA angle (OR 1.052, 95%CI 0.999-1.099, P =0.039) were independent risk factors for anterior circulation aneurysm, and the patients with history of ischemic stroke were less likely to have aneurysm (OR 0.569, 95%CI 0.313-1.017, P =0.045). Conclusions CCA TI was associated with the history of coronary heart disease, and ICA TI was associated with men. The degree of carotid artery tortuosity was an independent risk factor for anterior circulation aneurysm, and the patients with history of ischemic stroke were less likely to have anterior circulation aneurysm.

Key words: Carotid tortuosity; Tortuous index; Anterior circulation aneurysm; Risk factors

米热扎提·吐尔洪，阿西木江·阿西尔，卡合尔曼·卡德尔，成晓江，李雪亮，尼扎米丁江·热夏提，亚迪卡尔·艾合买提，麦麦提艾力·努尔东，亚尔麦麦提·阿塔唔拉. 颈动脉迂曲与前循环动脉瘤形成的相关性研究[J]. 中国卒中杂志, 2020, 15(03): 269-274.

Mirezhati TUERHONG, Aximujiang AXIER, Kaheerman KADEER, CHENG Xiao-Jiang, LI Xue-Liang, Nizamidingjiang REXIATI, Yadikaer AIHEMAITI,Maimaitiaili NUERDONG, Yaermaimaiti ATAWULA. Relationship between Carotid Tortuosity and Anterior Circulation Aneurysms[J]. Chinese Journal of Stroke, 2020, 15(03): 269-274.

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