颈内动脉颅外段迂曲与前循环脑梗死的相关性研究

Study on the Correlation between Extracranial Internal Carotid Artery Tortuosity and Anterior Circulation Cerebral Infarction

摘要: 目的：探讨颈内动脉颅外段血管迂曲与前循环脑梗死的相关性；方法：回顾性分析2022年5~10月于我院住院的1340例患者，记录入选者的临床资料(年龄、性别、高血压、高脂血症、糖尿病、吸烟史、冠心病及前循环脑梗死情况)。使用单因素及多因素Logistic回归分析前循环脑梗死与颈内动脉颅外段迂曲及其程度及一般危险因素的关系。结果：前循环脑梗死组与对照组之间，年龄、性别、高血压、糖尿病、冠心病、高脂血症、吸烟史以及血管迂曲程度等因素的差异均具有统计学意义。单因素Logistic回归分析揭示，与前循环脑梗死无显著相关性的只有简单迂曲，而折曲、卷曲和颈内动脉颅外段的迂曲程度及其他一般性危险因素均与之具有相关性。进一步的多因素Logistic回归分析表明，年龄、男性、高血压病史、糖尿病史、冠心病史、高脂血症病史以及吸烟史是前循环脑梗死的独立危险因素。然而，颈内动脉颅外段的迂曲指数无论是左侧(OR 0.92, 95%CI 0.24~3.53, P = 0.91)还是右侧(OR 2.60, 95%CI 0.66~10.23, P = 0.17)，均不构成前循环脑梗死的独立危险因素。结论：颈内动脉颅外段的折曲和卷曲形态与前循环脑梗死存在显著关联，但其迂曲程度并不是前循环脑梗死的独立危险因素。

Abstract: Objective: To explore the correlation between tortuosity of the extracranial internal carotid artery and anterior circulation cerebral infarction. Methods: A retrospective analysis of 1340 patients hospitalized from May to October 2022 was conducted, documenting clinical data such as age, gender, hypertension, hyperlipidemia, diabetes, smoking history, coronary artery disease, and the incidence of anterior circulation stroke. The relationship between anterior circulation cerebral infarction and the tortuosity of the extracranial segment of the internal carotid artery, including its degree and other risk factors, was assessed using univariate and multivariate Logistic regression analyses. Results: Significant differences were observed between the infarction group and the control group in factors like age, gender, hypertension, diabetes, coronary artery disease, hyperlipidemia, smoking history, and the degree of arterial tortuosity. Univariate analysis showed no significant correlation between simple tortuosity and stroke, while kinking, coiling, the degree of tortuosity, and other risk factors were correlated. Multivariate analysis identified age, male gender, history of hypertension, diabetes, coronary artery disease, hyperlipidemia, and smoking as independent risk factors for stroke. However, the tortuosity index of the extracranial segment, both left (OR 0.92, 95%CI 0.24~3.53, P = 0.91) and right (OR 2.60, 95%CI 0.66~10.23, P = 0.17), was not an independent risk factor. Conclusion: Kinking and coiling of the extracranial internal carotid artery are significantly associated with anterior circulation cerebral infarction, but the degree of tortuosity is not an independent risk factor.