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Objective To study the related influencing factors involving in vertebrobasilar dolichoectasia (VBD) and changing characteristics of hemodynamics of VBD. Methods Outpatients and inpatients with posterior circulation ischemia (PCI) underwent brain MRA from June 2008 to September 2009 were chosen; 116 patients met the standard of VBD were selected as VBD group and other 130 patients without VBD were as control group. The univariate analysis and multiple factor analysis were applied to study the correlation of hypertension,smoking,diabetes,low-density lipoprotein (LDL) and intracranial vascular variation with VBD.Transcranial Doppler (TCD) ultrasound and digital subtraction angiography (DSA) were applied to observe the hemodynamic changes and arteriosclerosis of these patients.Results Univariate analysis indicated that statistical significance on intracranial vascular variation,hypertension and smoking was noted between the VBD group and the control group (x2=13.530,P=0.000; x2=8.539,P=0.003; x2=3.959,P=0.047),while no statistical significance in diabetes and LDL was obtained between the 2 groups (x2=0.451,P=0.519; x2=0.220,P=0.881).Multiple factors analysis showed that VBD could be obviously related to intracranial vascular variation (OR=21.732, 95％CI:3.02-5.94),hypertension (OR=5.173,95％CI:1.23-3.05) and smoking (OR=3.145,95％CI:1.86-4.85).According to TCD,peak velocity (Vp),mean velocity (Vm) in the VBD group were significantly lower than those in the control group,but pulsatility index (PI) and resistant index (RI) in the VBD group were statistically higher (P＜0.05).DSA showed that the blood flow length of the VBD group was obviously shorter than that of the control group in the same time with statistical significance (P＜0.05). Conclusion Vascular variation,smoking and hypertension are related to VBD; and VBD leads to slow blood flow and aggravated arteriosclerosis,which may result in high incidence of stroke.
RESUMEN
The thrombin is a neurotoxic agent,which plays an important role in the course of brain edema and brain injury following intracerebral hemorrhage.This article reviews the neurotoxicity mechanisms of thrombin in intracerebral hemorrhage.