脑卒中高危人群Willis环特点.docVIP

脑卒中高危人群Willis环特点 　　【摘要】 目的：通过头CT血管成像（CTA）了解某地区脑卒中高危人群颅内血管Willis环的特点。方法：招募该地区脑卒中高危志愿者行头CTA检查，主要观察血管直径变化，对Willis环的变异进行分析，把所得数据与关于健康中国人的研究进行比较。结果：281人（男153人，女128人）的头CTA成像用于分析。Willis环完全不完整108例（38.44%），且随年龄增大而增高，但无统计学意义（P=0.78）。脑卒中家族史人群与中国健康人群Willis环不完整率分别是39%、17%，比较差异有统计学意义（P0.001）。本研究人群中缺血性卒中患者的平均年龄为（59.0±8.7）岁，高于非卒中人群（49.6±10.2）岁，比较差异有统计学意义（P0.001）。结论：脑卒中家族史人群Willis环的变异与年龄无关，其可能在胚胎早期阶段已发育，生后保持形态不变；此高危人群Willis环较高的不完整率可能是其脑卒中发生的一个重要原因。相似遗传背景的人群随年龄增高，外部因素的作用越来越重要。 　　【关键词】 脑卒中家族史； 头CTA； Willis环 　　【Abstract】 Objective： The present study clarified the characteristics of the intracranial vascular CoW in high-risk population of stroke. Method： High-risk volunteers of stroke underwent head computed tomography angiography （CTA） scan， focusing on diameter of vessels. Anatomic variations in the Circle of Willis was analyzed， the data were subsequently compared to the literature. Result： The head images of 153 men （54.4%） and 128 women （45.6%） were analyzed. The percentage of subjects with incomplete CoW increased with age but not significantly （P=0.78）. Compared to healthy Chinese people， the high-risk population of stroke had a higher percentage of incomplete CoW （39% vs.17%， P0.01）. Subjects who suffered ischemic stroke were older than those who had not， （59.0±8.7） vs. （49.6±10.2） years old， P0.001. Conclusion： The variations of the circle of Willis may be develop in the early embryonic stage， and the morphologies persist in post-natal life. Compared to healthy Chinese people， the population has a higher percentage of incomplete CoW. The cumulative effects of external factors become increasingly important with increasing age and similar genetic background in the development of stroke. 　　【Key words】 High-risk population of stroke； Computed tomography angiography； Circle of Willis 　　脑卒中发生与许多危险因素相关，包括性别、年龄、生活习惯及脑血管自身的变异等[1]。脑卒中家族史是卒中发生的独立危险因素[2]，具有脑卒中家族史的人群是脑卒中发生的高危人群。但目前还未有这种高危人群脑血管形态的研究。Willis环可通过血流转向而对脑血流低灌注做出反应。本单位流行病学调查发现天津蓟县某些农村地区的脑卒中年首发病率较高[3]。本文以脑卒中高危人群为研究对象，对其进行头CTA