摘要
目的探讨急性缺血性卒中患者的脑动脉狭窄分布特点及其危险因素。方法经MRI和磁共振血管造影（magnetic resonance angiography，MRA）检查的急性缺血性卒中患者，按是否存在脑动脉狭窄分为狭窄组与非狭窄组；狭窄组患者再根据狭窄部位分为单纯颅内狭窄组、单纯颅外狭窄组和颅内合并颅外狭窄组，根据年龄分为中青年组（〈60岁）和老年组（≥60岁），根据血管狭窄数量分为单支病变组和多支病变组，分析脑动脉狭窄的分布特点和影响因素。结果共纳入232例急性缺血性卒中患者，其中单纯颅内动脉狭窄者114例（62．0％），单纯颅外动脉狭窄者30例（16．3％），合并颅内外动脉狭窄者40例（21．7％）。前循环狭窄（76．6％）比后循环狭窄（33．7％）更多见，分别主要见于大脑中动脉（64．4％）和大脑后动脉（53．8％）。多变量logistic回归分析显示，年龄[优势比（oddsratio，OR）1．049，95％可信区间（confidenceinterval,CI）1．015～1．084；P=0．005]、高血压（OR10．063，95％C14．402～23．004；P〈0．001）、糖尿病（OR3．873，95％C11．141～13．147；P=0．030）、吸烟（OR3．311，95％C11．112～9．855；P=0．031）和纤维蛋白原（OR6．085，95％CI1．396～26．533；P=0．016）为急性缺血性卒中患者存在脑动脉狭窄的独立危险因素；高血压（OR10．779，95％CI4．468～26．007；P〈0．001）、糖尿病（OR3．593，95％CI1．018～12．685；P=0．047）、吸烟（OR4．408，95％CI1．403～13．826；P=0．011）为单纯颅内动脉狭窄的独立危险因素；高血压（OR6．143，95％C11．838～20．537；P=0．003）、糖尿病（OR8．179，95％CI1．844～36．287；P=0．006）、纤维蛋白原（OR2．410，95％CI1．046～5．551；P=0．039）为单纯颅外动脉狭窄的独立危险因素。合并颅内外动脉狭窄组C-反应蛋白（C-reactiveprotein，CRP）水平显著�
Objective To investigate the distribution characteristics of cerebral artery stenosis and its risk factors in patients with acute ischemic stroke.Methods The patients with acute ischemic stroke examined with MRI and magnetic resonance angiography (MRA) were divided into either a stenosis group or a non-stenosis group according to whether they had cerebral artery stenosis or not.The patients in the stenosis group were redivided into a simple intracranial stenosis,simple extracranial stenosis,and intracranial + extracranial stenosis subgroups according to their stenotic sites; they were redivided into either a young and middle-aged subgroup (＜60) or an elderly subgroup (≥60) according to their age; they were redivided into either a single-branch lesion subgroup or multibranch lesion subgroup according to the number of vascular stenosis.The distribution characteristics and influencing factors of cerebral artery stenosis were analyzed.Results A total of 232 patients with acute ischemic stroke were enrolled,and 114 of them (62.0％) were simple intracranial stenosis,30 (16.3％) were simple extracranial stenosis,and 40 (21.7％) were intracranial+ extracranial stenosis.The patients with anterior circulation stenosis (76.6％) were more common than those with posterior circulation stenosis (33.7％).They were mainly in the middle cerebral artery (64.4％) and posterior cerebral artery (53.8％) respectively.Multivariate logistic regression analysis showed that age (odds ratio [OR] 1.049,95％ confidence interval [CI] 1.015-1.084; P =0.005),hypertension (OR 10.063,95％ CI 4.402-23.004; P ＜ 0.001),diabetes (OR 3.873,95％ CI 1.141-13.147; P =0.030),smoking (OR 3.311,95 ％ CI 1.112-9.855; P =0.031),and fibrinogen (OR 6.085,95％ CI 1.396-26.533; P=0.016) were the independent risk factors for cerebral artery stenosis in patients with acute ischemic stroke; hypertension (OR 10.779,95％ CI 4.468-26.007; P＜ 0.001),diabetes (OR 3.593,95％ CII.018-12.685; P =0.047),and smoking (OR 4.408,95％ CI 1.403-13.826; P =0.0
出处
《国际脑血管病杂志》
北大核心
2014年第7期528-534,共7页
International Journal of Cerebrovascular Diseases
基金
连云港市卫生局课题基金（1415）
