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目的探讨动脉粥样硬化性缺血性脑血管病患者颅内外动脉狭窄的部位和年龄分布特征。方法选择存在脑动脉狭窄的缺血性脑血管病患者144例,按年龄分为青年组(18～44岁,12例)、中年组(45～59岁,45例)和老年组(≥60岁,87例)。通过CT血管造影检查,对脑动脉不同狭窄部位及年龄分布特征进行分析。结果 144例动脉狭窄或闭塞患者中,共检测到病变血管414支,单支性血管狭窄24例(16.7%),多发性狭窄120例(83.3%,P<0.01)。单纯颅内动脉狭窄和颅内合并颅外动脉狭窄发生率明显高于单纯颅外动脉(60.4%vs 31.3%vs8.3%,P<0.01)。颅内、外动脉病变好发部位依次为:大脑中动脉和椎动脉颅外段。单纯前循环狭窄和前后循环均狭窄发生率明显高于单纯后循环狭窄(35.4%vs 41.7%vs 22.9%,P<0.05,P<0.01)。青年组和中年组单纯颅内动脉狭窄发生率明显高于老年组(83.3%vs 75.6%vs 49.4%,P<0.05)。老年组单纯颅外动脉狭窄发生率明显高于中年组(12.6%vs 2.2%,P<0.05)。结论缺血性脑血管病患者脑动脉狭窄以多发性为主;颅内动脉狭窄的发生率高于颅外动脉;脑动脉狭窄分布有随年龄变化的特征性。
Objective To investigate the location and age distribution of intracranial and extracranial arterial stenosis in patients with atherosclerotic ischemic cerebrovascular disease. Methods A total of 144 patients with ischemic cerebrovascular disease with cerebral arterial stenosis were selected. They were divided into young group (18 to 44 years old, 12 cases), middle aged group (45 to 59 years old, 45 cases) and elderly group 60 years old, 87 cases). By CT angiography, cerebral artery stenosis and age distribution characteristics were analyzed. Results A total of 414 vascular lesions were detected in 144 patients with arterial stenosis or occlusion. Among them, 24 (16.7%) had single vessel stenosis and 120 had multiple stenosis (83.3%, P <0.01). The incidence of simple intracranial arterial stenosis and intracranial complicated with extracranial arterial stenosis was significantly higher than that of simple extracranial artery (60.4% vs 31.3% vs 8.3%, P <0.01). The intracranial and extra-arterial lesions were mainly followed by the extracranial segments of middle cerebral artery and vertebral artery. The incidence of simple anterior circulation stenosis and anterior and posterior circulation stenosis were significantly higher than those of simple posterior circulation stenosis (35.4% vs 41.7% vs 22.9%, P <0.05, P <0.01). The incidence of isolated intracranial arterial stenosis was significantly higher in the young and middle-aged groups than in the elderly group (83.3% vs 75.6% vs 49.4%, P <0.05). The incidence of isolated extracranial arterial stenosis in the elderly group was significantly higher than that in the middle-aged group (12.6% vs 2.2%, P <0.05). Conclusions Cerebral artery stenosis is predominant in patients with ischemic cerebrovascular disease. The incidence of intracranial arterial stenosis is higher than that of extracranial artery. The distribution of cerebral artery stenosis is characteristic of age.