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颈动脉迂曲与动脉粥样硬化性颈动脉狭窄的相关性研究

[Study of correlation between carotid artery tortuosity and atherosclerotic carotid artery stenosis].

作者信息

Chen K P, Wang J J, Wang L J, Lu J, Qi P, Hu S, Yang X M, Wang H F, Wang D M

机构信息

Graduate School of Peking Union Medical College, Beijing Institute of Geriatric, Department of Neurosurgery, Beijing Hospital, Beijing 100730, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2017 Aug 1;55(8):608-612. doi: 10.3760/cma.j.issn.0529-5815.2017.08.011.

Abstract

To investigate the correlation between carotid artery tortuosity and atherosclerotic carotid artery stenosis. A total of 73 patients who underwent carotid computed tomography angiography with unilateral atherosclerotic carotid artery stenosis at Department of Neurosurgery of Beijing Hospital from January 2011 to June 2016 were retrospectively reviewed. There were 51 males and 22 females ranging from 48 to 90 years old, the average age was (65.9±9.5) years. There were 38 patients with carotid stenosis in the left carotid artery and 35 in the right, the stenosis degree of carotid artery ranged from 30% to 90% with the median was 44.0% (25.5%). According to the degree of carotid artery stenosis, the patients were classified into mild stenosis group and moderate/severe stenosis group. There were 43 patients in the mild stenosis group with an average stenosis degree of (37.5±5.4)%, there were 30 patients in moderate/severe stenosis group with an average stenosis degree of (65.6±10.9)%. The carotid artery (CCA) tortuosity, extracranial internal carotid artery (EICA) tortuosity and CCA-ICA bifurcation tortuosity were quantified by measuring the CCA tortuosity index, EICA tortuosity index and the internal carotid artery (ICA) angle, respectively. Comparison of diseased and normal carotid arteries was performed using test or Wilcoxon signed-ranked test. There were no statistically significant differences in CCA tortuosity index (=-0.584, =0.559), ICA angle (=0.278, =0.781), and EICA tortuosity index (=-0.377, =0.706) between diseased and normal carotid arteries in 73 patients. The diseased carotid arteries showed larger ICA angles (39.0° (19.0°) . 30.0° (15.0°)) (=-2.439, =0.015) in the mild stenosis group, but smaller ICA angles ((31.5±11.7)° . (39.1±16.2)°) (=-2.529, =0.017) in the moderate/severe stenosis group, compared with the contralateral normal carotid arteries. There was no statistically significant difference in CCA (=-0.720, =0.472; =-0.013, =0.990) and EICA tortuosity index (=-0.349, =0.727; =-0.114, =0.909) between diseased and normal carotid arteries. Compared with normal carotid arteries, carotid arteries with mild atherosclerotic stenosis demonstrate a more tortuous CCA-ICA bifurcation, while those with moderate/severe stenosis demonstrate a straighter CCA-ICA bifurcation. There is no correlation between CCA, EICA tortuosity and carotid artery stenosis.

摘要

探讨颈动脉迂曲与动脉粥样硬化性颈动脉狭窄之间的相关性。回顾性分析2011年1月至2016年6月在北京医院神经外科接受单侧动脉粥样硬化性颈动脉狭窄的颈动脉计算机断层血管造影检查的73例患者。其中男性51例,女性22例,年龄48至90岁,平均年龄为(65.9±9.5)岁。左侧颈动脉狭窄38例,右侧35例,颈动脉狭窄程度为30%至90%,中位数为44.0%(25.5%)。根据颈动脉狭窄程度,将患者分为轻度狭窄组和中/重度狭窄组。轻度狭窄组43例,平均狭窄程度为(37.5±5.4)%;中/重度狭窄组30例,平均狭窄程度为(65.6±10.9)%。分别通过测量颈总动脉(CCA)迂曲指数、颅外颈内动脉(EICA)迂曲指数和颈内动脉(ICA)角度来量化CCA迂曲、EICA迂曲和CCA-ICA分叉处迂曲。采用检验或Wilcoxon符号秩和检验对病变颈动脉与正常颈动脉进行比较。73例患者病变颈动脉与正常颈动脉在CCA迂曲指数(=-0.584,=0.559)、ICA角度(=0.278,=0.781)和EICA迂曲指数(=-0.377,=0.706)方面差异无统计学意义。与对侧正常颈动脉相比,轻度狭窄组病变颈动脉的ICA角度更大(39.0°(19.0°). 30.0°(15.0°))(=-2.439,=0.015),但中/重度狭窄组病变颈动脉的ICA角度更小((31.5±11.7)°.(39.1±16.2)°)(=-2.529,=0.017)。病变颈动脉与正常颈动脉在CCA(=-0.720,=0.472;=-0.013,=0.990)和EICA迂曲指数(=-0.349,=0.727;=-0.114,=0.909)方面差异无统计学意义。与正常颈动脉相比,轻度动脉粥样硬化狭窄的颈动脉在CCA-ICA分叉处更迂曲,而中/重度狭窄的颈动脉在CCA-ICA分叉处更直。CCA、EICA迂曲与颈动脉狭窄之间无相关性。

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