急性缺血性卒中颅外颈动脉狭窄临床分布特点及危险因素分析

发布时间：2018-07-03 06:07

本文选题：卒中 + TOAST分型　；参考：《重庆医科大学学报》2016年08期

【摘要】：目的:分析急性缺血性卒中(acute ischemic stroke,AIS)颅外颈动脉狭窄(extracranial carotid artery stenosis,ECAS)的发生率及其在急性卒中Org 10172治疗试验(trial of Org 10172 in acute stroke treatment,TOAST)各亚型中的分布特点,并探讨其危险因素。方法:连续收集本院神经内科2014年3月至2015年2月收治的375例AIS患者的临床资料,依照TOAST分型标准分为5型,分析ECAS在AIS患者及其亚型中的分布规律;根据颈部血管超声检查结果将AIS患者分为ECAS组(n=81)和对照组(n=294),比较2组患者的临床资料并进行多因素logistic回归分析。结果:AIS患者ECAS发生率为35.73%,其中中-重度狭窄率为21.60%,16.80%分布于大动脉粥样硬化(1arge artery atherosclerosis,LAA)型卒中,高于小动脉闭塞、心源性脑栓塞及其他病因型卒中,差异有统计学意义(P0.01);ECAS组年龄、糖尿病、高脂血症、颈动脉斑块及不稳定斑块的发生率高于对照组,差异有统计学意义(P0.05);多因素Logistic回归分析显示糖尿病(OR=1.782,95%CI=1.048~3.029,P=0.033)、高脂血症(OR=1.824,95%CI=1.037~3.208,P=0.037)、颈动脉斑块(OR=3.673,95%CI=2.014~6.698,P=0.000)是AIS患者ECAS的独立危险因素。结论:AIS患者ECAS发生率较以往有所升高,其中中-重度ECAS在TOAST分型中主要分布于LAA型卒中;糖尿病、高脂血症和颈动脉斑块是AIS患者ECAS的独立危险因素。
[Abstract]:Objective: to analyze the incidence of extracranial carotid stenosis (extracranial carotid artery stenosisus) in acute ischemic stroke (acute ischemic stroke-AIS) and its distribution in the subtypes of (trial of Org 10172 in acute stroke treatmentlist in acute stroke treatment trial (Org 10172), and to explore its risk factors. Methods: the clinical data of 375 patients with AIS from March 2014 to February 2015 were collected and divided into 5 types according to the toast classification criteria. The distribution of ECAS in AIS patients and its subtypes was analyzed. According to the results of cervical vascular ultrasound, the patients were divided into two groups: the control group and the control group. The clinical data of the two groups were compared and multivariate logistic regression analysis was performed. Results the incidence of 1arge artery was 35.73. The incidence of severe stenosis was 21.60% and 16.80% in 1arge artery arteriosclerosis type LAA, which was higher than that in small artery occlusion, cardiogenic cerebral embolism and other etiological stroke. The difference was statistically significant (P0.01). The incidence of diabetes mellitus, hyperlipidemia, carotid artery plaque and unstable plaque was significantly higher than that of control group (P0.05), and multivariate logistic regression analysis showed that diabetes mellitus (OR1.782C1.048), hyperlipidemia (OR1.824995 CI 1.0373.208P0.037) and carotid plaque (OR3.67395CI2.0146.698P0.000) were independent risk factors of ECAS in AIS patients. Conclusion the incidence of ECAS in patients with AIS is higher than that in the past, and the incidence of ECAS in patients with severe ECAS is mainly distributed in type A stroke in toast classification, diabetes mellitus, hyperlipidemia and carotid plaque are independent risk factors of ECAS in AIS patients.
【作者单位】：兰州大学第二医院神经内科;
【基金】：兰州科技计划资助项目(编号:2011-1-134)
【分类号】：R743.3

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