大动脉粥样硬化脑梗死的危险因素分析
发布时间：2018-10-17 22:36
【摘要】：背景我国脑梗死发病率正逐年上升,受到人们的关注,脑梗死危险因素的筛查是预防脑梗死的有效手段,对其危险因素的掌握已成为临床诊治的关键。目前国内公认的中国缺血性卒中亚型(Chinese ischemic stroke subclassification,CISS)将脑梗死分5型。其中,大动脉粥样硬化(LAA)脑梗死是最常见的一种亚型,往往病情发展迅速,后果严重,预后差。国内外针对该亚型脑梗死发病的危险因素目前公认的有很多,也有研究表明Willis环变异是其危险因素,但目前缺少包括Willis环变异在内的多因素分析。目的按照CISS分型的标准,探讨LAA脑梗死发病的相关危险因素。研究Willis环变异与LAA脑梗死的相关性,以及应用多因素Logistic回归分析了解Willis环变异对LAA脑梗死的影响力以及筛选出LAA脑梗死的高危因素。为临床提供LAA脑梗死发生的相关因素,为今后LAA脑梗死的预防起到指导作用。方法回顾性选取2015年01月01日-2016年12月31日于我院住院的患者,LAA组为根据最新国内急性脑梗死诊断标准,MRI/CT证实有急性脑梗死发生,且符合CISS分型中LAA诊断标准的急性脑梗死患者;对照组为临床表现主要为头晕,不符合急性脑梗死诊断标准,头颅MRI/CT未见明显异常的非脑梗死患者。先采用单因素分析筛选出与LAA有关的危险因素,再采用多因素非条件logistic回归筛选出相应的高危因素。结果(1)单因素分析:性别、高血压级别、Willis环类型、Willis环中前交通动脉变异、空腹血糖、甘油三脂、体质指数与对照组相比,差异有统计学意义(P0.05),余差异无统计学意义(P0.05)。(2)相关因素分析:Willis环类型与ACoA成正相关;吸烟、饮酒与男性成正相关;颈动脉斑块与HDL成负相关,与年龄、高血压级别成正相关;LDL与TC成正相关。(3)哑变量赋值:Willis环类型生成3个哑变量,选用Willis环Ⅰ型做参考类型,结果显示:与Willis环Ⅰ型比较,Willis环Ⅱ型、Ⅳ型的β0、OR=2.603、8.409;对于高血压级别生成3个哑变量,选用高血压0级做参考类型,结果显示:与高血压0级相比,高血压2级、3级的β0、OR=4.331、4.5。(4)多因素logistic回归分析:Willis环Ⅳ型、高血压2级、高血压3级3个变量经Wald检验差异有统计学意义(P0.05)。结论(1)本研究中单因素分析发现:性别、高血压级别、Willis环类型、Willis环中前交通动脉变异、空腹血糖、甘油三脂、体质指数与LAA脑梗死发生有关。(2)哑变量Logistic回归结果显示:与Willis环Ⅰ型比较,Willis环Ⅱ型、Ⅳ型为LAA脑梗死的危险因素(OR=2.603、8.409);与高血压0级相比,高血压2级、3级为LAA脑梗死的危险因素(OR=4.331、4.5)。(3)多因素Logistic回归分析显示:Willis环Ⅳ型、高血压2级、高血压3级与LAA脑梗死相关性高。
[Abstract]:Background the incidence of cerebral infarction in China is increasing year by year. People pay close attention to it. Screening for risk factors of cerebral infarction is an effective means to prevent cerebral infarction, and mastering its risk factors has become the key of clinical diagnosis and treatment. At present, cerebral infarction is classified into 5 types of cerebral infarction (Chinese ischemic stroke subclassification,CISS), which is recognized as ischemic stroke type in China. Among them, atherosclerosis (LAA) cerebral infarction is the most common subtype, the disease often develops rapidly, the consequence is serious, the prognosis is poor. There are many risk factors for this subtype of cerebral infarction at home and abroad, and some studies show that the variation of Willis ring is its risk factor, but there is a lack of multivariate analysis, including Willis loop variation. Objective to investigate the risk factors of cerebral infarction in LAA according to the criteria of CISS classification. To study the correlation between Willis ring variation and LAA cerebral infarction, and to use multivariate Logistic regression analysis to understand the influence of Willis ring variation on LAA cerebral infarction and to screen out the high risk factors of LAA cerebral infarction. To provide clinical related factors for the occurrence of LAA cerebral infarction, and to play a guiding role in the prevention of LAA cerebral infarction in the future. Methods the patients in our hospital from January 01, 2015 to December 31, 2016 were selected retrospectively. According to the latest diagnostic criteria of acute cerebral infarction in China, MRI/CT confirmed the occurrence of acute cerebral infarction. The patients with acute cerebral infarction in accordance with the diagnostic criteria of LAA in CISS classification, the control group were mainly dizziness, not in accordance with the diagnostic criteria of acute cerebral infarction, and there was no obvious abnormality in head MRI/CT in patients with non-cerebral infarction. The risk factors related to LAA were screened by univariate analysis, and then the risk factors were screened by multivariate unconditioned logistic regression. Results (1) single factor analysis: sex, grade of hypertension, type of Willis ring, variation of anterior communicating artery in Willis ring, fasting blood glucose, triglyceride, body mass index compared with control group. The difference was statistically significant (P0.05), the other differences were not statistically significant (P0.05). (2) related factors analysis: Willis loop type and ACoA positive correlation; smoking, drinking and male positive correlation; carotid plaque and HDL negative correlation, and age, (3) the assignment of mute variables: Willis ring type generated 3 dummy variables, and Willis ring 鈪，
本文编号：2278246
[Abstract]:Background the incidence of cerebral infarction in China is increasing year by year. People pay close attention to it. Screening for risk factors of cerebral infarction is an effective means to prevent cerebral infarction, and mastering its risk factors has become the key of clinical diagnosis and treatment. At present, cerebral infarction is classified into 5 types of cerebral infarction (Chinese ischemic stroke subclassification,CISS), which is recognized as ischemic stroke type in China. Among them, atherosclerosis (LAA) cerebral infarction is the most common subtype, the disease often develops rapidly, the consequence is serious, the prognosis is poor. There are many risk factors for this subtype of cerebral infarction at home and abroad, and some studies show that the variation of Willis ring is its risk factor, but there is a lack of multivariate analysis, including Willis loop variation. Objective to investigate the risk factors of cerebral infarction in LAA according to the criteria of CISS classification. To study the correlation between Willis ring variation and LAA cerebral infarction, and to use multivariate Logistic regression analysis to understand the influence of Willis ring variation on LAA cerebral infarction and to screen out the high risk factors of LAA cerebral infarction. To provide clinical related factors for the occurrence of LAA cerebral infarction, and to play a guiding role in the prevention of LAA cerebral infarction in the future. Methods the patients in our hospital from January 01, 2015 to December 31, 2016 were selected retrospectively. According to the latest diagnostic criteria of acute cerebral infarction in China, MRI/CT confirmed the occurrence of acute cerebral infarction. The patients with acute cerebral infarction in accordance with the diagnostic criteria of LAA in CISS classification, the control group were mainly dizziness, not in accordance with the diagnostic criteria of acute cerebral infarction, and there was no obvious abnormality in head MRI/CT in patients with non-cerebral infarction. The risk factors related to LAA were screened by univariate analysis, and then the risk factors were screened by multivariate unconditioned logistic regression. Results (1) single factor analysis: sex, grade of hypertension, type of Willis ring, variation of anterior communicating artery in Willis ring, fasting blood glucose, triglyceride, body mass index compared with control group. The difference was statistically significant (P0.05), the other differences were not statistically significant (P0.05). (2) related factors analysis: Willis loop type and ACoA positive correlation; smoking, drinking and male positive correlation; carotid plaque and HDL negative correlation, and age, (3) the assignment of mute variables: Willis ring type generated 3 dummy variables, and Willis ring 鈪，
本文编号：2278246
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