| Background:Cerebrovascular disease is refers to the brain dysfunction caused by cerebrovascular disease, its incidence, mortality and morbidity were higher, and heart disease, constitute the three main causes of human malignant tumors. Furthermore, clinical stroke is one of the most common cerebrovascular disease, including ischemic stroke and hemorrhagic stroke.As the following, we will introduce ischemic stroke.In view of the cerebral vascular distribution characteristics and the clinical symptoms and signs of differences, it is divided into anterior circulation stroke and posterior circulation stroke. Because of the diversity and complexity of its symptoms and signs,posterior circulation ischemia’s symptoms vary from mild dizziness, nausea, vomiting, and limb paralysis, paresthesia, even difficulty in swallowing, drinking water choking cough, seriousiy it can affects breathing, heartbeat center, life-threatening.Posterior circulation ischemia(PCI) first is ischemic changes, the position is in the vertebral basilar artery system, it is caused by the cerebrovascular disease resulting by a variety of reasons, including transient ischemic attack(TIA) and cerebral infarction, accounted for 20% of ischemic cerebral apoplexy. As non-invasive magnetic resonance angiography(MRA) and computed tomography angiography,(CTA) applying, found that the diameter of vertebral artery is about 3 mm,and in the vast majority of people, both sides are usually asymmetrical.when this asymmetry is very obvious, unilateral vertebral artery is formed named advantage(vertebral artery dominance, VAD), or rather on either side of the vertebral artery in the diameter of pipe, one side more directly connected to the basal artery. But there have been no unified conclusion about its formation mechanism. The effects of posterior circulation hemodynamics, blood vessel injury of significance, the research on the formation of atherosclerosis remains to be going. At home and abroad, posterior circulation ischemia is the lack of large sample research data. The article will briefly discusse the meaning of the advantages of vertebral artery in the cycle of cerebral infarction,the influential for posterior circulation TIA, and long-term exposure to common risk factors of cerebrovascular disease, whether it can promote the vascular variation in order to reduce posterior circulation ischemic events、unnecessary morbidity and mortality. Method:1.Collect between December 2014 and December 2015 at the department of neurology of posterior circulation ischemia patients(including posterior circulation cerebral infarction 139 cases, 28 cases posterior circulation TIA), 167 cases were retrospectively analyzed, Analysis the various risk factors if there is a correlation with the advantage of vertebral artery; measure the vertebral artery diameter, based on the statistics on the left side of the vertebral artery, the right side of the vertebral artery, no advantage;carrying on the comprehensive analysis about such clinical datas.2.Determine the advantages of the lateral vertebral artery, depanding on the noninvasive vascular imaging(magnetic resonance angiography, MRA) and intracranial vascular CT angiography(CTA),in order to analysis the depengency of advantages of vertebral artery and posterior circulation ischemia. Result:1. Posterior Circulation Ischemia are 167 cases, the nonadvantage are 32 cases, accounted for 19.05%. 90 cases are on the left side of the vertebral artery advantage, accounted for 53.57%, the right side of the vertebral artery advantage are 46 cases(27.38%). Patients with vertebral artery advantage is significantly more than the advantages, and has the larger ratio on the left side of the edge.2. Average age is 60.37 + /- 10.3 among the no advantage, on the left side of the vertebral artery advantage with an average age of 60.74 10.08 mm, the right side of the vertebral artery advantage with an average age of 58.09 + /- 10.12, no difference on the three groups of age; Among of the three groups, men is more than women in Gender.3. Vertebral artery advantage, has a history of smoking in 62 cases, accounting for 49.2%, has a history of drinking,45 cases(35.71%), 79 cases with hyperlipemia, accounted for 62.70%; No advantage in 13 patients with smoking history, accounting for 40.63%, has a history of drinking, 9 cases(28.13%), 19 cases with hyperlipidemia, accounting for 59.38%. Among them, the history of smoking, drinking and hyperlipidemia in the incidence of vertebral artery advantage group is significantly higher than the no advantage group.4. Gender of partial regression coefficient is 0.555, Wald test result is 0.0422 < 0.05,OR is 1.574, OR worth 95% confidence interal is(0.151, 0.151), with statistical significance; Age of partial regression coefficient is 0.009, Wald test result is 0.009 < 0.05, OR is 2.009, OR worth 95% confidence interal is(1.951, 1.951), with statistical significance; Hyperlipidemia partial regression coefficient was 0.080, Wald test result is 0.010 < 0.05, OR is 1.683, OR worth 95% confidence interal is(1.272, 1.272), with statistical significance;the conclusion is that age, sex and hyperlipidemia is a risk factor for vertebral artery advantage; High blood pressure of partial regression coefficient is 0.145, Wald test result is 0.297 > 0.05,OR is 2.156, OR worth 95% confidence interal is(2.687,3.945), with statistical nonsignificance; Diabetes of partial regression coefficient is 1.434, Wald test result is 2.804 >0.05,OR is 0.238, OR worth 95% confidence interal is(0.045,1.277), with statistical nonsignificance; Smoking of partial regression coefficient is 0.430, Wald test result is 0.284 > 0.05,OR is 3.651, OR worth 95% confidence interal is(3.134,4.160), with statistical nonsignificance; Drinking of partial regression coefficient is 0.418, Wald test result is 0.225 >0.05,OR is 0.658, OR worth 95% confidence interal is(0.117,3.699), with statistical nonsignificance;And if there are pertinences about high blood pressure, diabetes, smoking, drinking and vertebral artery advantage,there have no statistically significant correlation. Conclusion:1.The high incidence of vertebral artery advantage in the circulation ischemia, suggest that there is some possible correlation about the vascular variation contributing to the posterior circulation ischemia.2.Advantages of vertebral artery, mostly is on the left side of the vertebral artery.3.Smoking, drinking and hyperlipidemia in the incidence of vertebral artery advantage is higher than the no advantage group, at the same time, multiple linear regression analysis showed that age, gender, hyperlipidemia is a risk factor for vertebral artery edge, and high blood pressure, diabetes, smoking, drinking and vertebral artery advantage,they are no related with statistical significance.4. Multiariable Logistic regression analysis showed that age, gender and hyperlipidemia are considered as the risk factors for 弹 the vertebral artery advantage,and that smoking, drinking, hypertension and diabetes are no correlation with vertebral artery advantages. |
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