| Objective: By analyses clinical materials of 236 cases posterior circulation ischemic to approach the clinical characteristics and risk factors,to provide reference basis for screening, treatment, preventing. Methods :Totally 236 patients with posterior circulation ischemia as case group were admitted from March. 2008 to March. 2010 in the neurological wards of North China Coal Medical University in this study, including 210 patients with posterior circulation infarction and 26 patients with trensient ischemic attack. Demographic characteristics,vascular risk factors, neurologic impairment marks and other auxiliary examinations during hospitalization in the 24 hours related to the outcome were collected. Refering to NEMC-PCR study,the patients were divided into follow groups ( proxima1, middle, distal and combination group, or single , multiple, or unilateral, bilateral, or lacune infarct, non lacune infarct ) according to the infarcts locations and characteristics on MRI/CT .The risk factors in each group and prognosis were analysed. Meanwhile, the major risk factors were compared with that from 236 patients with anterior circulation infarction.Results1. The clinical symptoms such as vertigo,hemiplegia,dysarthria were commnon and the clinical signs such as sensation disorders,ataxia,Romberg sign were commnon in patients with posterior circulation ischemic.2. Of the 236 patients with posterior circulation ischemia, extracranial vertebral artery lesions (25% ) was the most commnon,other vascular lesions followed by basilar artery (18.2% ), intracranial vertebral artery (14.0%), posterior cerebral artery (9.3%), subclavian artery(3.4%),other artery (11.9%), no vascular lesions (18.2%).3. Time in hospital:The proportion of time 2 weeks～3weeks,>3 weeks about be in hospital in posterior circulation ischemia group was higher than the anterior circulation ischemia group, There were significant differences (P<0.05).4. Comparison prognosis between the two groups: the rate of no disability of the posterior circulation ischemia group was higher than the anterior circulation ischemia group; severe disability and mild disability was lower than the anterior circulation ischemia group,but there were no significant differences between two groups(P>0.05).5.The proportion of accompanying infection and upper gastrointestinal hemorrhage in the posterior circulation ischemia group was higher than the anterior circulation ischemia group,There were significant differences (P<0.05).;The proportion of brain-heart syndrome was higher than the anterior circulation ischemia group,but there were no significant differences between two groups(P>0.05).6.Patients with posterior circulation ischemia, hypertension was the most common risk factors ( 71.2% ) , followed by diabetes mellitus ( 47.9% ) , hyperlipedemia ( 41.9% ) , previous stroke history(36% ) , heart disease (26.3% ),smoking history(25.8% )and drinking history(19.9% ). The risk factors in patients with posterior circulation ischemia war similar to that of anterior circulation infarction.7. The average age of posterior circulation infarction [(67.22±9.29) years] was higher than that of anterior circulation infarction [ (64.31±10.42)years ] ( P < 0. 05). The incidence rate of hypertension(71.2%),hyperlipidemia(41.9%), diabetes mellitu(s47.9%)in posterior circulation infarction were higher than that of anterior circulation infarction (56.8%,36.4%,28%)( P < 0. 05～0. 01). But rate of smoking(25.8%),drinking(19.9%), heart disease(26.3%)were lower than that of anterior circulation ischemia group (34.7%,29.9%,40.3%) , there were significant differences ( P < 0. 05).8. Of the 236 patients with posterior circulation ischemia,there were 154 men with an average age of( 66.88±9.78) years and 82 women with an average age of (66.85±8.33) years.Men posterior circulation ischemia patients were more likely than women patients to have a history of moking(32.5%vs 13.4%,P<0.05),drinking (26.6%vs 7.3%,P < 0.001),previous stroke history(40.9%vs 26.8%,P<0.05),whereas women patients were more likely than men patients to have diabetes mellitus(42.9%vs 57.3%,P<0.05) and heart diseas(20.1% vs 37.8%,P<0.05).9. There was significant difference about the mean of risk factors of the posterior circulation ischemia group, it was higher than the anterior circulation ischemia group (P<0.05).10.Blood sugar, cholesterol total;total cholesterol and low density lipoprotein of the posterior circulation ischemia group were higher than those of anterior circulation infarction, there were significant differences (P<0.05). other chemical examinations there were no significant differences between two groups(P>0.05).11.The most common location of infarcts was distal territory (31.9% ) , followed by combination (29.5%),middle (22.4% ) , proxima1 (16.2% ). The average age(63.09±9.58) of proximal group was significant lower than that of other groups( P < 0. 05). The incidence rate of hyperlipidemia (79.4% ) was significant higher than that of other groups ( P < 0. 05). The incidence rate of heart diseas (32.8% ) in distal territory was higher than that of other groups ( P < 0. 05).12. Patients with posterior circulation infarction, hyperlipidemia in single lesion group(58.9%) were higher than that of multiple lesion group(32.1%); the previous stroke history in multiple lesion group (43.1%) were higher obviously than that of single lesion group (19.2%), there were significant differences (P < 0.05). other risk factors there were no significant differences between two groups(P>0.05).13. Patients with posterior circulation infarction, hyperlipidemia in unilateral lesion group(51.8%)were higher than that of bilateral lesion group(34.6%); the previous stroke history in bilateral lesion group (41.7%) were higher obviously than that of unilateral lesion group (24.1%), there were significant differences (P<0.05). other risk factors there were no significant differences between two groups(P>0.05).14. Patients with posterior circulation infarction, the average age of lacune infarct group (72.78±8.92)was higher than that of non lacune infarct group(64.38±6.49)(P<0.01);diabetes mellitus in lacune infarct group were higher than that of non lacune infarct group (P<0.05);the incidence rate of heart diseas and hyperlipidemia in lacune infarct group were lower than that of non lacune infarct group(P<0.05), there were significant differences (P<0.05). other risk factors there were no significant differences between two groups(P>0.05).Conclusions:1.The clinical manifestations in patients with PCI are complicate, vertigo, hemiplegia and dysarthria were common clinical symptoms,and sensation disorders,ataxia,Romberg sign were commnon clinical signs,so the characteristic presentation is helpful for diagnosis.2.The patients with posterior circulation ischemia are older,increased accompanied sickness,prolonged course of disease and have more cerebrovascular risk factors than those of patients with anterior circulation infarction.3.The most common location of infarcts was distal territory, followed by combination and middle. The average age of proximal group was significant lower than that of other groups. The incidence rate of hyperlipidemia was significant higher than that of other groups. The incidence rate of heart diseas in distal territory was higher than that of other groups.4.The common risk factors in patients with posterior infarction are hypertension, diabetes mellitus, hyperlipidemia and previous stroke history, The risk factors in patients with posterior circulation ischemia war similar to that of anterior circulation infarction. |
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