摘要
目的分析急性缺血性脑血管病患者脑动脉粥样硬化性狭窄的分布情况及危险因素。方法选取江苏大学附属徐州医院神经外科2018-02—2021-02收治的256例急性缺血性脑血管病患者为研究对象,分析病例资料和数字血管造影检查结果,探讨动脉粥样硬化性狭窄分布情况和危险因素。结果256例患者有狭窄病变600支,407支为颅内动脉狭窄,占67.83%;193例为颅外动脉狭窄,占32.17%。前循环和后循环分别为412支和188支,分别占68.67%和31.33%;107支血管累及大脑中动脉,占17.83%,为最常见累及血管。重度狭窄患者C反应蛋白(2.45±0.48)ng/L,白细胞介素-6水平(268.96±37.12)pg/L,中度狭窄患者C反应蛋白和白细胞介素-6水平分别为(2.36±0.54)mg/L和(252.55±43.72)pg/L;轻度狭窄患者C反应蛋白和白细胞介素-6水平分别为(2.21±0.32)mg/L和(244.78±40.32)pg/L,组间对比有统计学差异(P<0.05)。Logistic多因素分析显示,颅内动脉狭窄以高血压和糖尿病为独立危险因素;颅外动脉狭窄以性别、年龄、高血压和糖尿病为独立危险因素;同时狭窄者以性别、年龄、高血压、冠心病和糖尿病为独立危险因素,均存在统计学差异(P<0.05)。结论急性缺血性脑血管病患者脑动脉粥样硬化性狭窄以颅内动脉狭窄为主,前循环狭窄更为多发,主要累及大脑中动脉,脑动脉粥样硬化性狭窄以高血压和糖尿病为独立危险因素。
Objective To analyze the distribution and risk factors of cerebral atherosclerotic stenosis in patients with acute ischemic cerebrovascular disease.Methods A total of 256 patients with acute ischemic cere⁃brovascular disease admitted to the Department of Neurosurgery of Affiliated Xuzhou Hospital of Jiangsu Universi⁃ty from February 2018 to February 2021 were selected as the research objects.The medical records and digital an⁃giography results of the patients were observed and recorded,and the distribution and risk factors of atherosclerotic stenosis were analyzed.Results There were 600 stenotic lesions in 256 patients,407(67.83%)of which were intracranial artery stenosis,193(32.17%)of which were extracranial artery stenosis.There were 412 vessels in an⁃terior circulation and 188 vessels in posterior circulation,with a probability of 68.67%and 31.33%,respectively;107 vessels involved middle cerebral artery,with a probability of 17.83%,which was the most common vessel in⁃volved;C-reactive protein and interleukin-6 levels were(2.45±0.48)ng/L and(268.96±37.12)pg/L in severe stenosis patients,and(2.36±0.54)mg/L in moderate stenosis patients,respectively.The levels of CRP and IL-6 in mild stenosis patients were(2.21±0.32)mg/L and(244.78±40.32)pg/L,with significant difference between the two groups(P<0.05).Logistic multivariate analysis showed that hypertension and diabetes were independent risk factors for intracranial stenosis;gender,age,hypertension and diabetes were independent risk factors for intracrani⁃al stenosis.At the same time,gender,age,hypertension,coronary heart disease and diabetes were the independent risk factors of stenosis,and there were statistical differences between the data(P<0.05).Conclusion Cerebral atherosclerotic stenosis in patients with acute ischemic cerebrovascular disease is mainly intracranial stenosis,and anterior circulation stenosis is more frequent,mainly involving middle cerebral artery.Hypertension and diabetes are independent risk factors for cerebral atherosclerotic stenosis.
作者
李法强
纪艾玲
王帅帅
LI Faqiang;JI Ailing;WANG Shuaishuai(Xuzhou Tumor Hospital/Xuzhou Branch of Jiangsu Provincial People’s Hospital,Xuzhou 221005,China)
出处
《中国实用神经疾病杂志》
2023年第3期339-343,共5页
Chinese Journal of Practical Nervous Diseases
