双侧椎动脉不对称性与椎动脉起始段狭窄的相关性分析OA北大核心CSTPCD

Objective To analyze the correlation between vertebral artery asymmetry and vertebral artery origin stenosis(VAOS)lesions in population without risk factors for cardiovascular and cerebrovascular diseases.Methods A total of 6 423 participants without cardiovascular and cerebrovascular high-risk factors who underwent cervical atherosclerosis ultrasound screening in the"standardized evaluation database for cerebral vascular ultrasound screening in the high-risk population of stroke"from December 2019 to December 2021 were consecutively enrolled.The general information of the participants was collected before the examination,including gender,age,body mass index(BMI),and bilateral vertebral artery ultrasound parameters,i.e.,the internal diameter of the intervertebral segment(V2 segment)and the degree of VAOS(mild,moderate,severe,and occlusion)assessed by hemodynamic parameters(peak systolic flow velocity[PSV],end-diastolic flow velocity[EDV],and PSVinitiation/PSVintervertebral segment).According to the ultrasound results,the participants were divided into VAOS group and no stenosis group(non-VAOS group).Vertebral artery diameter ≤ 2.0 mm was defined as vertebral artery hypoplasia(VAH).According to the difference in the inner diameter of the V2 segment of the bilateral vertebral arteries,the participants were classified as vertebral artery dominance(VAD)group(inner diameter difference ≥1.2 mm)and non-VAD group(inner diameter difference＜1.2 mm).In the final statistical analysis,if there is a side involved,each group will be counted by the number of cases,and if no side differentiation is involved,each group will be counted by the number of cases.Taking the occurrence of VAOS as the dependent variable,the general information and anatomical factors(VAH,VAD)were analyzed by univariate Logistic regression.The item of P＜0.05 was used as the independent variable,and the independent influencing factors of VAOS were further analyzed by multivariate Logistic regression.Results A total of 6 423 participants were included,including 1 985 males and 4 438 females,with an average age of(43±13)years from 19 to 80 years.There were 628 cases in the VAD group and 5 795 cases in the non-VAD group.(1)Compared with the VAD group,the proportion of females in the non-VAD group was higher(69.9％vs.61.3％,P＜0.01),and the age was younger([43±13]vs.[45±14]years,P＜0.01),and the proportion of those aged＜40 years was higher than that in the VAD group(46.3％vs.38.4％,P＜0.01).The proportion of VAH patients and the incidence of VAOS were lower than those in the VAD group(0.6％vs.17.2％and 1.5％vs.4.0％,respectively,both P＜0.01).(2)Univariate Logistic regression analysis of the incidence of VAOS among participants without cardiovascular and cerebrovascular risk factors showed that the proportion of male,age,BMI,VAH and VAD ratios in the VAOS group were higher than those in the non-VAOS group,with statistical significance(all P＜0.05).Multivariate Logistic regression analysis showed that male(OR,1.92,95％CI 1.30-2.85,P=0.001),age(OR,1.12,95％CI1.10-1.14,P＜0.01)and VAD(OR,2.14,95％CI 1.30-3.40,P=0.002)were independent risk factors for VAOS in participants without cardiovascular and cerebrovascular risk factors.Conclusions The occurrence of VAD is affected by gender and age.VAD is an independent risk factor for VAOS in population without cardiovascular and cerebrovascular risk factors.