回顾性分析主动脉弓上大动脉炎性血管病变受累血管分布特征与脑缺血发生率的差异性。

纳入2005年8月至2013年6月在首都医科大学宣武医院连续住院观察，临床及数字减影血管造影（DSA）证实为主动脉弓上血管大动脉炎性病变患者共84例，年龄11~70岁，中位年龄39岁。通过彩色多普勒超声成像（CDFI）检测比较主动脉弓上大动脉炎性病变受累动脉、分布特征与脑缺血症状（短暂脑缺血发作、头晕、晕厥、双眼或单眼黑朦等）发生率的差异性。

924支（84例）弓上血管中大动脉炎性血管病变累及352支（38.1%），其中女性患病率（92.9%）明显高于男性（7.1%）。颈总动脉（CCA）病变累及发生率为94.0%，其次锁骨下动脉（SA）为82.1%。双侧CCA病变检出率高于双侧SA病变，分别为75%、50%，两者比较差异有统计学意义（χ²=15.732，P=0.003）。左侧CCA与SA的同时病变检出率高于右侧CCA与SA同时病变检出率（64.3% vs 56.0%，χ²=12.777，P=0.001）。同一个体存在≥3支动脉病变者占69.1%（58例），明显高于<3支动脉病变者30.9%（26例）。双侧CCA、双侧SA、右侧CCA和SA同时病变者、左侧CCA和SA同时病变者，脑缺血发生率均较高，分别为74.6%、78.6%、76.5%、76.4%，而≥3支动脉病变者脑缺血发生率69.1%，显著高于<3支动脉病变者脑缺血发生率30.9%（χ²=6.674, P=0.010）。

CDFI对主动脉弓上大动脉炎性血管病变分布特征的研究，患者早期发现早期治疗病变血管，减少缺血性脑血管病变的发生率具有重要的临床价值。

To retrospectively analyze the distribution of artery involvement above the aortic arch and differences incidence of cerebral ischemic in patients with Takayasu’s arteritis (TA) by color Doppler flow imaging (CDFI).

A total of 84 cases (aged from 11 to 70 years old, median age 39 years old) continuous observed from August 2005 to June 2013 were included in this study. All patients were detected by CDFI and confirmed by digital subtraction angiography (DSA) and clinical examination. The distribution of the involved arteries were analyzed.

A total of 924 vessels (84 patients) was detected, 352 (38.1%) arteries involved inflammatory lesions. The prevalence rate of female was higher than male (92.9% and 7.1%) significantly. The symptoms of cerebral ischemic included dizziness, syncope, TIA, amaurosis etc. The involvement rate of common carotid artery (CCA) was the highest (94.0%), followed by the subclavian arterythe (SA) (82.1%). The detecting rate of bilateral CCA was higher than that of bilateral SA, 75% and 50% (χ²=15.732, P=0.003), respectively. The rate of combined lesions of CCA and SA were higher in left (64.3%) than the right 56% (χ²=12.777, P=0.001). Most patients had multiple vascular (≥ 3 vessels) diseases (69.1%). No significant difference was found in the incidence of cerebral ischemia symptoms in patients with bilateral CCA or SA lesions (74.6% with78.6%) (χ²=0.219, P=0.411). No significant difference was found inthe patients with left or right CCA combined with SA lesions (76.5% with 76.4% , χ²=1.230, P=0.602) also. The incidence of cerebral ischemia for greater than 3 vessel disease was significantly higher than less vessels (69.1% with 30.9%) (χ²=6.674, P=0.010).

The study in the distribution of aortic arch vascular lesion for the patients with Takayasu arteritis by CDFI is valuable for the early detection and treatment of vascular lesions, and decresing the incidence of ischemic cerebrovascular disease.