高血压患者无症状性颅内动脉狭窄的cta、tcd检测及相关危险因素研究-study on cta, tcd and related risk factors of asymptomatic intracranial artery stenosis in hypertensive patients.docxVIP

上海交通大学硕士学位论文上海交通大学硕士学位论文 PAGE PAGE 4USE OF CT ANGIOGRAPHY AND TRANSCRANIAL DOPPLER ULTRASOUND TO EVALUATE ASYMPTOMATIC INTRACRANIAL VASCULAR STENOSIS AND INVESTIGATE ITS RISK FACTORS IN ESSENTIAL HYPERTENSIVE PATIENTSABSTRACTOBJECTIVE To investigate the clinical features and risk factors of asymptomatic intracranial vascular stenosis in patients with essential hypertension, and to evaluate the accuracy in diagnosis of intracranial arterial stenosis between CT angiography (CTA) and transcranial Doppler ultrasound (TCD).METHODS Patients (780 cases) in hospital with essential hypertension were recruited. Exclusive criteria were: secondary hypertension, history of stroke and transient ischemic attack, other intracranial diseases. Intracranial vascular stenosis was evaluated by CTA. Clinical information, biochemical and special exam results were analysis to determine the risk factors of asymptomatic intracranial vascular stenosis. Some of the patients underwent TCD simultaneously, to evaluate the TCD as a screening modality forasymptomatic intracranial vascular stenosis with the use of CTA.RESULTS Among 780 patients in hospital, 166 had asymptomatic intracranial vascular stenosis; the prevalence rate was 21.28%. The most common site of stenosis was in middle cerebral artery (42.02%), followed by vertebral artery (20.62%), anterior cerebral artery (11.67%), internal carotid artery (10.89%), posterior cerebral artery (9.34%) and basilar artery (5.45%). The stenosis in internal arterial system was common than in vertebrobasilar arterial system (64.59% vs 35.41%, P=0.000). The pathological degree of asymptomatic intracranial stenosis is slight, and the majority is single artery stenosis (66.87%).The total rate of stenosis artery in elderly hypertensive patients was higher than that in non-elderly. Statistic correlation of hypertension duration to the prevalence of stenosis arterial was found. The patient with arterial stenosis had significantly higher in sys