本文選題：椎動脈優(yōu)勢 + 椎動脈��； 參考：《大連醫(yī)科大學》2014年碩士論文

【摘要】：目的：評價椎動脈優(yōu)勢與眩暈及基底動脈彎曲的關系，探討椎動脈優(yōu)勢導致眩暈的機制。 方法：收集在遼寧省人民醫(yī)院以眩暈為主要表現(xiàn)的住院患者的臨床資料，根據(jù)MRA檢查結果將患者分為椎動脈優(yōu)勢組及非椎動脈優(yōu)勢組，通過眩暈程度評分比較兩組患者眩暈的程度，包括眩暈恢復需要的時間；根據(jù)MRA影像，對比兩組基底動脈彎曲的發(fā)生率、彎曲的方向、形態(tài)；基底動脈的直徑、長度以及雙側椎動脈直徑差異，并分析椎動脈直徑差異與基底動脈彎曲長度的相關性。 結果: （1）共收集眩暈患者183例，其中椎動脈優(yōu)勢組與非優(yōu)勢組分別為98例、85例，椎動脈優(yōu)勢的發(fā)生率為98/183（53.55%）；兩組患者的性別、年齡、高血壓史、糖尿病史、吸煙史、飲酒史、頸椎病、頸動脈狹窄等血管危險因素均無統(tǒng)計學差異（P＞0.05）。 （2）椎動脈優(yōu)勢組眩暈嚴重程度評分為3.31±1.28，非椎動脈優(yōu)勢組2.54±1.46，差異有統(tǒng)計學意義（P=0.000）。椎動脈優(yōu)勢組眩暈恢復時間（4.52±1.77）天，明顯較非優(yōu)勢組（3.28±1.45）天延長，差異有統(tǒng)計學意義（P=0.008） （3）98例椎動脈優(yōu)勢組中左側優(yōu)勢者69例（69/98，70.41%）、右側優(yōu)勢29例（29/98，29.59%）,左側優(yōu)勢明顯高于右側優(yōu)勢（70.41%vs29.59%）。 (4)椎動脈優(yōu)勢患者中基底動脈彎曲者為53例，基底動脈彎曲發(fā)生率為54.08%(53/98),顯著高于非優(yōu)勢組16.47%(14/85),差異有統(tǒng)計學意義（2=27.75，P=0.000）。椎動脈優(yōu)勢組中左側彎曲者12例、右側彎曲者41例，提示基底動脈以向椎動脈優(yōu)勢對側彎曲為主。基底動脈的彎曲形狀優(yōu)勢組與非優(yōu)勢組均以C型彎曲者多見（69.81%，64.29%）。 （5）椎動脈優(yōu)勢組基底動脈彎曲長度（BL，3.27±3.13）mm，明顯高于非優(yōu)勢組（1.70±2.59）mm，差異有統(tǒng)計學意義（P=0.021）。椎動脈優(yōu)勢組基底動脈直徑、基底動脈理論長度（BAL）與非優(yōu)勢組對比差異無統(tǒng)計學意義(P＞0.05)。 （6）椎動脈直徑左側為（3.86±0.48）mm、右側為（2.94±1.01）mm，統(tǒng)計學處理兩者相差有意義，即左側較右側增粗。使用Pearson相關檢驗，結果發(fā)現(xiàn)椎動脈直徑差異與BAL相關（r=0.097，P＞0.05），與BL呈正相關(r=0.780，P=0.000)，與眩暈嚴重程度呈正相關（r=0.615，，P=0.000）。 結論:（1）眩暈患者椎動脈優(yōu)勢發(fā)生率高，且椎動脈優(yōu)勢者眩暈程度嚴重，眩暈恢復時間延長，提示椎動脈優(yōu)勢與眩暈相關； （2）椎動脈優(yōu)勢者基底動脈彎曲的發(fā)生率高，其基底動脈的彎曲方向一般朝向椎動脈優(yōu)勢的對側，以C型彎曲多見； （3）雙側椎動脈的直徑差異與基底動脈彎曲長度（BL）呈正相關，椎動脈優(yōu)勢越明顯，基底動脈彎曲長度越長，眩暈的程度越嚴重。提示椎動脈優(yōu)勢可能通過導致基底動脈彎曲而引起眩暈發(fā)作。
[Abstract]:Objective: to evaluate the relationship between vertebral artery dominance and vertigo and basilar artery curvature, and to explore the mechanism of vertigo caused by vertebral artery dominance. Methods: the clinical data of the inpatients with vertigo as the main manifestation in Liaoning Provincial people's Hospital were collected. According to the MRA results, the patients were divided into two groups: the dominant vertebral artery group and the non-vertebral artery dominant group. The degree of vertigo in the two groups was compared by the score of vertigo degree, including the time needed for the recovery of vertigo. According to MRA images, the incidence, direction, shape, diameter of the basilar artery were compared between the two groups. The length of vertebral artery and the diameter of bilateral vertebral artery were different, and the relationship between the diameter difference of vertebral artery and the length of basilar artery bending was analyzed. Results: (1) A total of 183 patients with vertigo were collected, including 98 cases of vertebral artery dominance group and 85 cases of non-dominant group, the incidence of vertebral artery dominance was 98 / 183 (53.55%), the sex, age, history of hypertension, history of diabetes, history of smoking, sex, age, history of hypertension, history of diabetes, history of smoking, and the incidence of vertebral artery dominance were 98 / 183 (53.55%), respectively. There was no significant difference in the risk factors of alcohol consumption, cervical spondylopathy and carotid artery stenosis (P > 0. 05). (2). The score of vertigo severity in the dominant vertebral artery group was 3. 31 鹵1. 28, and that in the non-vertebral artery dominant group was 2. 54 鹵1. 46. The difference was statistically significant (P < 0. 05). The recovery time of vertigo in the dominant vertebral artery group was (4.52 鹵1.77) days, which was significantly longer than that in the non-dominant group (3.28 鹵1.45) days. The difference was statistically significant (P < 0. 008) (3) among 98 patients with vertebral artery dominance, 69 (69 / 98) were left dominant (69 / 980.41%), 29 were right (29 / 98) 29.59%, the left was significantly higher than that of right (79. 41 vs 29. 59%). (4). 53 cases of basilar artery curvature were found in the patients with vertebral artery dominance (79. 41 vs 29. 59%). (4). The incidence of basilar artery curvature was 54.08% (53 / 98), which was significantly higher than that of non-dominant group (16.47%) (14 / 85). In the vertebral artery dominant group there were 12 cases with left curvature and 41 cases with right curvature suggesting that the basilar artery was predominantly contralateral bent to the vertebral artery. The curve length of basilar artery in the dominant group (69.81%, 64.29%). (5) was significantly higher than that in the non-dominant group (1.70 鹵2.59 mm, P 0.021), and the length of the basilar artery in the dominant group was (3.27 鹵3.13) mm, significantly higher than that in the non-dominant group (P 0.021). There was no significant difference in the diameter of basilar artery and the theoretical length of basilar artery between the dominant group and the non-dominant group (P > 0. 05). (6). The diameter of the vertebral artery was (3. 86 鹵0. 48) mm on the left side and (2. 94 鹵1. 01) mm on the right side. That is, the left side is thicker than the right. Using Pearson correlation test, it was found that the diameter of vertebral artery was correlated with BAL (r = 0.097, P > 0.05), BL (r = 0.780, P = 0.000), and with the severity of vertigo (r = 0.615, P = 0.000). Conclusion: (1) the incidence of vertebral artery dominance in patients with vertigo is high, and the degree of vertigo is serious and the recovery time of vertigo is prolonged in patients with vertebral artery dominance, which indicates that the advantage of vertebral artery is related to vertigo, (2) the incidence of basilar artery curvature is high in patients with vertebral artery dominance. The bending direction of the basilar artery is generally oriented to the opposite side of the dominant vertebral artery, and the C-type curvature is more common. (3) the diameter difference of the bilateral vertebral artery is positively correlated with the length of the basilar artery curvature (BL), and the more obvious the vertebral artery dominance is, The longer the basilar artery bends, the more severe the vertigo is. The results suggest that vertebral artery dominance may cause vertigo by bending the basilar artery.
【學位授予單位】：大連醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R741

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