摘要目的 探讨胚胎型大脑后动脉(fPCA)对急性大动脉粥样硬化性(LAA)性脑梗死严重程度及短期功能预后的影响. 方法 连续收集南京军区南京总医院卒中登记系统(自2013年8月至2016年12月)以及皖南医学院弋矶山医院卒中数据库(自2017年1月至12月)中LAA性脑梗死患者689例,根据三维时间飞跃法MRI血管成像(3D-TOF-MRA)结果并结合最大强度投影法(MIP)将研究对象分为fPCA组(n=185)和非fPCA组(n=504).采用美国国立卫生研究院卒中量表(NIHSS)评估脑梗死严重程度,通过患者3个月时的改良Rankin量表(mRS)评分评估其短期功能预后.分析fPCA与LAA的相关性并明确LAA的独立危险因素. 结果 fPCA组与非fPCA组患者性别、年龄、高血压病、糖尿病、高脂血症等基线资料差异均无统计学意义(P＞0.05).多因素Logistic回归分析显示:fPCA不是前后循环LAA性脑梗死患者严重程度及短期功能预后的独立危险因素(P＞0.05),但年龄是LAA性脑梗死患者严重程度及不良预后的独立危险因素(P＜0.05). 结论 fPCA是常见的脑血管变异类型,但对LAA性脑梗死患者脑梗死严重程度及预后均无显著影响.

abstractsObjective To explore the effect of fetal-type posterior cerebral artery (tPCA) on short-term outcomes and degrees of severity of acute large artery atherosclerosis (LAA) stroke.Methods A total of 689 patients with LAA stroke were consecutively collected from Nanjing Stroke Registry Program (August 2013 to December 2016) and stroke database of Yijishan Hospital of Wannan Medical College (January 2017 to December 2017) according to the strict inclusion criteria.Patients were divided into fPCA group (n=185) and non-fPCA group (n=504) according to the results of 3D-time of flight-MR angiography and maximum intensity projection.National Institutes of Health Stroke Scale (NIHSS) was used to assess the degrees of severity of stroke and mild stroke was defined as NIHSS scores ≤ 7.There-month modified Rankin scale (mRS) was used to evaluate the short-term stroke outcomes,and favorable functional outcome was defined as MRS score ≤ 1.The correlation between fPCA and LAA stroke was analyzed and the independent risk factors of LAA stroke were identified.Results There were no significant differences in gender,age,hypertension,diabetes,and hyperlipidemia between fPCA group and non-fPCA group (P＞0.05).Multivariable Logistic regression analysis showed that there was no significant association of fPCA with severity and short-term outcomes in patients with acute LAA stroke in either anterior or posterior circulation (P＞0.05);however,age was an independent risk factor for severe stroke and unfavorable stroke outcome (P＜0.05).Conclusion fPCA is a common variant of cerebral circulation,but has no significant influence in severity and short-term outcome of LAA stroke.