Abstract:

Objective To investigate the recurrence rate and mortality of cerebral ischemic stroke in patients with vertebral artery origin occlusion (VAOO). Methods According to the verification of digital subtraction angiography (DSA), 156 cases of unilateral vertebral artery origin occlusion were divided into 2 groups: symptomatic group (n =98) and asymptomatic group (n =58). The follow-up study of these patients were performed for at least 2 years to observe newly occurred cerebral infarction and death from any cause. Results The annual newly occurred cerebral infarction rate was 5.1% and the annual mortality rate was 0.4% in the patients with VAOO. The cumulative incidence of newly occurred cerebral infarction in symptomatic group and asymptomatic group didn’t have statistical significance (P >0.05). Kaplan- Meier analysis showed that there were no significant differences in the incidence of endpoint event and the proportion of opened collateral circulation between symptomatic group and asymptomatic group (P =0.690; P =0.566; 23.5% vs 27.6%, respectively). The patient ratio of the collateral circulation in patients with new cerebral infarction didn’t have obvious significance (35.7% vs 22.7%, P =0.148). Conclusion The annual new cerebral infarction rate of patients with VAOO is 5.1%, and the prognosis is relatively good.

Key words: Vertebral artery origin occlusion; Cerebral infarction; Follow-up; Prognosis

摘要：

目的 随访椎动脉起始处闭塞患者的缺血性脑卒中发生率与死亡率。 方法 1 56例经数字减影血管造影术（digital s ubtraction a ngiography，DSA）证实的单侧椎动脉起始部 闭塞患者，根据患者有无缺血性脑血管病症状分为有症状组（n =98）和无症状组（n =58），对患者进 行随访，至少2年，观察新发症状性脑梗死、任何原因死亡。 结果 椎动脉起始处闭塞患者平均年新发脑梗死发生率为5.1%，平均年死亡率为0.4%。有症状 组累积新发脑梗死发生率和无症状组比较差异无显著性（P >0.05）；Kapl an-Mei er曲线显示，有症状 组终点事件发生率与无症状组差异无显著性（P =0.690）；两组间侧支循环开放比率差异无显著性 （23.5% vs 27.6%，P =0.566），无新发与新发脑梗死侧支循环的开放比率差异无显著性（35.7% vs 22.7%，P =0.148）。 结论 单侧椎动脉起始部闭塞的患者年新发脑梗死发生率为5.1%，预后相对较好。

关键词: 椎动脉起始部闭塞; 脑梗死; 随访; 预后