症状性动脉粥样硬化性颅内动脉狭窄的影像学特征与内科治疗效果的相关性分析

发布时间：2018-07-17 03:49

【摘要】：目的探讨影像学特征对症状性动脉粥样硬化性颅内动脉狭窄患者内科治疗效果的预测价值。方法在2015年1月-2016年6月选取我院接受规范化住院治疗的症状性动脉粥样硬化性颅内动脉狭窄患者136例,全部是首次以急性脑梗死入院治疗的患者,其中男性75例,女性61例,平均年龄58.57±8.32岁。根据发病后6h-1周美国国立卫生研究院卒中量表(National institutes of health stroke,NIHSS)评分将患者分为进展性卒中组29例和非进展组107例。收集患者临床基本资料及实验室化验、影像学检查资料,并比较两组的差异,对有统计学意义的单因素作为自变量进行多因素Logistic回归分析,多因素logistic回归分析s ICAS患者的影像学特征与其内科治疗效果的相关性。结果136例症状性动脉粥样硬化性颅内动脉狭窄患者中进展组29例,非进展组107例,单因素分析显示进展组中糖化白蛋白水平(P=0.016)、低密度脂蛋白水平(P=0.032)、同型半胱氨酸水平(P=0.047)、脑微出血比例(P=0.038)、颅内责任血管狭窄程度(重度或闭塞)比例(P=0.010)均明显高于非进展组。多因素logistic回归分析表明,糖化白蛋白(OR=1.214,95%CI:1.071-1.376,P=0.002)及责任血管狭窄程度(OR=3.044,95%CI:1.127-8.227,P=0.023)是s ICAS内科治疗效果较差的独立预测因素。结论:s ICAS患者的影像学特征与其内科治疗效果存在相关性,颅内动脉重度狭窄或闭塞和糖化白蛋白水平是s ICAS内科治疗效果较差的重要预测因素。
[Abstract]:Objective to evaluate the predictive value of imaging features in patients with symptomatic atherosclerotic intracranial artery stenosis. Methods from January 2015 to June 2016, 136 patients with symptomatic atherosclerotic intracranial artery stenosis who received standardized hospitalization in our hospital were selected, all of whom were hospitalized for the first time with acute cerebral infarction (75 males and 61 females). The average age was 58.57 卤8.32 years old. The patients were divided into progressive stroke group (29 cases) and non-progressive group (107 cases) according to the National institutes of health Stroke scale (NIHSS) score of 6h-1 week after onset. The basic clinical data, laboratory tests and imaging data were collected, and the differences between the two groups were compared. Multivariate logistic regression analysis was used to analyze the statistical significance of single factor as independent variable. Multivariate logistic regression analysis was used to analyze the correlation between the imaging features of sICAS patients and the effect of medical treatment. Results among 136 patients with symptomatic atherosclerotic intracranial stenosis, 29 were in progressive group and 107 in non-progressive group. Univariate analysis showed that the levels of glycosylated albumin (Pn0. 016), low density lipoprotein (P0. 032), homocysteine (P0. 047), cerebral microhemorrhage (P0. 038) and the degree of intracranial responsible vascular stenosis (P0. 010) in the progressive group were significantly higher than those in the non-progressive group. Multivariate logistic regression analysis showed that the degree of glycosylated albumin (OR 1.214C95CI: 1.071-1.376P0. 002) and the degree of responsible vascular stenosis (OR 3.04495) were independent predictors of the poor efficacy of SICAS. Conclusion the imaging features of the patients with SICAS are correlated with the effect of internal medicine treatment. The severe stenosis or occlusion of intracranial artery and the level of glycosylated albumin are the important predictors of the poor efficacy of the internal medicine treatment of SICAS.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.3

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