本文選題：鎖骨下動(dòng)脈盜血 + 動(dòng)脈狹窄　； 參考：《新疆醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：探討鎖骨下動(dòng)脈盜血(subclavian steel syndrome, SSS)的危險(xiǎn)因素、臨床特點(diǎn)、診斷及腦血管造影的特點(diǎn)等。方法：回顧性分析2010年4月至2013年7月在新疆醫(yī)科大學(xué)一附屬醫(yī)院就診診斷為鎖骨下動(dòng)脈盜血并行TCD和腦血管造影檢查的患者41例為觀察組；選取同期住院排除鎖骨下動(dòng)脈盜血并行TCD及腦血管造影檢查的患者82例。收集兩組患者的吸煙史、高血壓病史、糖尿病病史、腦梗死或TIA史、臨床表現(xiàn)、輔助檢查結(jié)果等臨床資料,從而總結(jié)出鎖骨下動(dòng)脈盜血的臨床特點(diǎn)。結(jié)果：(1)鎖骨下動(dòng)脈盜血組空腹血糖(FG)、總膽固醇(TC)、低密度脂蛋白(LDL-C)、甘油三酯(TG)、吸煙、高血壓、糖尿病、腦梗死或TIA與對(duì)照組比較具有顯著性差異(均P0.05)。二元Logistic回歸模型分析顯示：高血壓(OR=5.795)、糖尿病(OR=4.528)、吸煙(OR=2.135)、腦梗死或TIA(OR=2.129)、LDL-C(OR=2.009)、 TC(OR=2.091)、TG(OR1.969)。(2)左側(cè)多于右側(cè),左：右比例為3：1,男女之間無(wú)顯著性差異。(3)70.73%的患者合并有多支血管的病變,男女之間無(wú)明顯差別。(4)臨床表現(xiàn)為單純后循環(huán)缺血癥狀9例,單純上肢缺血癥狀13例,后循環(huán)缺血并上肢缺血癥狀11例,無(wú)任何臨床表現(xiàn)8例。結(jié)論：鎖骨下動(dòng)脈盜血獨(dú)立相關(guān)的危險(xiǎn)因素依次是高血壓、糖尿病、吸煙、腦梗死或TIA、LDL-C、TC、TG;大多數(shù)存在腦血管病的危險(xiǎn)因素,而動(dòng)脈粥樣硬化是鎖骨下動(dòng)脈盜血的主要致病因素；其多發(fā)于左側(cè),而且男女之間無(wú)明顯差異,常合并多支血管病變；鎖骨下動(dòng)脈盜血并非罕見,相當(dāng)部分患者無(wú)明顯的臨床癥狀而被誤診或漏診,其臨床癥狀與側(cè)枝循環(huán)有關(guān)；TCD是鎖骨下動(dòng)脈盜血的早期篩查的首選方法,而DSA檢查是診斷鎖骨下動(dòng)脈盜血的金標(biāo)準(zhǔn)。
[Abstract]:Objective: to investigate the risk factors, clinical features, diagnosis and cerebral angiography of subclavian artery steal blood (subclavian steel syndrome,). Methods: from April 2010 to July 2013, 41 patients who were diagnosed as subclavian artery theft and TCD and cerebral angiography in a affiliated hospital of Xinjiang Medical University were analyzed retrospectively. 82 patients with subclavian artery steal and TCD and cerebrovascular angiography were selected in the same period. The history of smoking, hypertension, diabetes, cerebral infarction or TIA, clinical manifestations and auxiliary examination results were collected to summarize the clinical characteristics of subclavian artery steal blood. Results: (1) fasting blood glucose (FG), total cholesterol (TC), low density lipoprotein (LDL-C), triglyceride (TG), smoking, hypertension, diabetes, cerebral infarction or TIA in the subclavian artery steal group were significantly different from those in the control group (P0.05). The results of binary logistic regression analysis showed that hypertension (OR 5.795), diabetes mellitus (OR4.528), smoking (OR2.135), cerebral infarction or TIA (OR2.129) LDL-C (OR2.009), TC (OR2.091) TG (OR 1.969). (2) were more in left than right (OR 1.969). (2), the ratio of left to right was 31. There was no significant difference between male and female. There was no significant difference between male and female. (4) the clinical manifestations were simple posterior circulation ischemia in 9 cases, simple upper limb ischemia in 13 cases, posterior circulation ischemia with upper limb ischemia in 11 cases, and no clinical manifestations in 8 cases. Conclusion: the independent risk factors associated with subclavian artery theft are hypertension, diabetes, smoking, cerebral infarction or TIA-LDL-CfT TG.The majority of the risk factors are cerebrovascular diseases, and atherosclerosis is the main risk factor of subclavian artery theft. The subclavian artery steal blood is not rare, and most of the patients are misdiagnosed or missed diagnosis without obvious clinical symptoms, their clinical symptoms are related to collateral circulation. TCD is the first choice for early screening of subclavian artery theft, and DSA is the gold standard for diagnosis of subclavian artery theft.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R743.3

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本文編號(hào)：2063560