脑动脉狭窄合并冠状动脉狭窄患者心脑联合造影特点研究

Features of Combined Cardiac and Cerebral Angiography in Patients with Cerebral Artery Stenosis and Coronary Artery Stenosis

摘要: 目的：探讨脑动脉狭窄合并冠状动脉狭窄患者心脑联合造影特点，并进一步分析脑动脉狭窄与冠状动脉狭窄的相关性。方法：选取2019年1月~2020年10月在我院神经内科或心内科住院并同期行心脑联合造影发现脑动脉狭窄合并冠状动脉狭窄患者91例，回顾性分析上述患者的临床资料及造影病变特征。分别采用脑动脉粥样硬化评分(CAS)和Gensini评分方法评估脑动脉狭窄程度和冠状动脉狭窄程度，通过上述两种评分方法来明确脑动脉狭窄程度是否与冠状动脉狭窄程度相关。结果：91例脑动脉狭窄合并冠脉狭窄患者中男性73例(80.2%)、女性18例(19.8%)，平均年龄64.80 ± 8.42岁，其中冠状动脉狭窄中三支病变比例占比40.7%、狭窄程度≥70%比例占比78.0%，Gensini评分中位数(四分位数) [M(P25,P75)]为[24.0(12.0,42.5)]。脑动脉狭窄中颈内动脉颅外段狭窄占比78.0%、椎动脉颅外段狭窄占比54.9%、多处狭窄占比85.7%、狭窄程度≥70%占比82.4%，CAS评分中位数(四分位数) [M(P25,P75)]为[2(2,3)]。CAS评分与Gensini评分具有明确相关性(P < 0.05)。颈内动脉颅外段狭窄程度、椎动脉颅外段狭窄程度均与Gensini评分明显相关(P < 0.05)。结论：脑动脉狭窄合并冠状动脉狭窄患者其心脑血管狭窄程度及病变范围多数较重，脑动脉狭窄与冠状动脉狭窄密切相关。因此对于临床发现脑动脉狭窄或者冠状动脉狭窄患者，尽早进行心脑联合造影，可有效指导心脑血管病的合理治疗。

Abstract: Objective: To analyze the clinical features of combined cardiac and cerebral angiography in patients with cerebral artery stenosis and coronary artery stenosis. Methods: Clinical data of 91 patients in neurology department or cardiology department from January 2019 to October 2020 were collected. The patients underwent combined angiography and found stenosis in cerebral artery and coronary artery. Clinical characteristics and angigraphy features were retrospectively analyzed. The rela-tionship between the degree of cerebral artery stenosis and the severity of coronary artery was further compared. Results: There were 73 males (80.2%) and 18 females (19.8%) in the patients with stenosis in cerebral artery and coronary artery. The average age was 64.80 ± 8.42 years. A to-tal of 91 patients with coronary artery stenosis, among which 29 patients had one-single coronary artery disease, 27 patients had coronary artery disease and 37 patients (40.7%) had three-branch coronary artery disease (3VD). 71 cases(78.0%) of coronary artery stenosis had severe stenosis (78.0%). The average Gensini score [M(P25,P75)] is [24.0(12.0,42.5)]. In 91 patients with cerebral artery stenosis, of which extracranial segment of ICA stenosis accounted for 78.0%, extracranial segment of VA stenosis accounted for 54.9%. At the same time, multiple lesions (85.7%) and severe stenosis (82.4%) were more common. The average CAS score [M(P25,P75)] is [2(2,3)]. There was a significant statistical relationship between Gensini score and CAS score. Also there was a significant statistical relationship between Gensini score and stenosis of both the extracranial segment of ICA and extracranial segment of VA (P < 0.05). Conclusion: The scope and degree of stenosis in the cere-bral artery and coronary artery were severe in most patients. There was a significant relationship between Gensini score and stenosis of cerebral artery. For patients with cerebral artery stenosis or coronary artery stenosis, combined angiography should be performed as early as possible, so as to take early intervention measures to effectively guide the reasonable treatment of cardiovascular and cerebrovascular diseases.