代谢综合征对症状性颅内动脉粥样硬化性多支病变的影响  

Effects of metabolic syndrome on multi-vessel lesions of symptomatic intracranial atherosclerosis

作　　者：朱双根[1] 朱幼玲[1] 黄治飞[1] 翟登月[1] 张婷婷[1] 周群[1] 穆燕芳[1] 刘德志[2] 刘文华[2] 徐格林[2] 刘新峰[2] 

机构地区：[1]安徽医科大学第三附属医院(暨合肥市第一人民医院)神经内科,合肥230061 [2]南京大学医学院临床学院南京军区南京总医院神经内科

出　　处：《中华医学杂志》2013年第21期1622-1625,共4页National Medical Journal of China

基　　金：国家自然科学基金（81000501）

摘　　要：目的探讨代谢综合征（MS）与颅内动脉粥样硬化性多支病变的相关性。方法选取2009年4月至2010年10月南京军区南京总医院神经内科有症状性颅内动脉粥样硬化性连续住院患者139例，借助磁共振血管成像和（或）CT血管成像和（或）全脑血管造影明确颅内动脉粥样硬化情况，按病变支数分为单支病变组和多支病变组；采用ATPm修订版的MS诊断标准，明确两组MS的发生率；分析影响多支病变的危险因素，并探讨MS与颅内动脉粥样硬化性多支病变的相关性。结果139例症状性颅内动脉粥样硬化患者共发现210支颅内动脉病变，其中59例（42．4％）有2支或以上病变。所有患者MS发生率为70．5％，其中单支病变组和多支病变组分别为56．3％和89．8％（P〈0．001）。颅内病变支数随着MS组分个数增加而递增（P〈0．001）。另外，分析MS组分后发现仅高血糖与多支病变关系密切（P=0．002）。Logistic回归多因素分析显示MS与颅内动脉多支病变有关（P=0．006）。结论MS是颅内动脉粥样硬化性多支病变的独立预测因素，积极干预MS或许可以预防颅内动脉粥样硬化性多支病变的发生。Objective To explore the effects of metabolic syndrome （MS） on muhi-vessel lesions of symptomatic intracranial atherosclerosis. Methods During April 2009 and October 2010, a total of 139 consecutive hospitalized patients with symptomatic intracranial atherosclerosis were recruited to undergo magnetic resonance angiography （MRA） or/and CT angiography （CTA） or/and digital subtraction angiography （DSA） to measure the stenotic degree and numbers of intracranial atherosclerosis. They were divided into 2 groups according to lesion numbers： single and muhi-vessel lesions. MS was defined by the criteria of the Adult Treatment Panel m to examine the incidences of MS. The risk factors were analyzed for multi-vessel lesions of symptomatic intracranial atherosclerosis to explore the relationship between MS and multi-vessel lesions. Results Among them, 210 intraeranial atherosclerotic lesions were documented. Fifty-nine （42.4%） patients had two or more lesions （group with multi-vessel lesions）. The incidence of MS was 70.5%. The rates of MS in groups of single and multi-vessel lesions were 56.3% and 89.8% respectively. And statistical significance existed between two groups （P 〈 0. 001 ）. Moreover, the number of MS components increased gradually with the number of lesions （P 〈 0. 001 ）. For the analysis of individual criteria for MS, only abnormal glycemia was found to be associated with multi-vessel lesions （P = 0. 002）. And multiple Logistic regression analysis showed that MS was associated with multi-vessel lesions ofintracranial atherosclerosis （P = 0. 001 ）. Conclusions MS is an independent predictor for multi-vessel lesions of intracranial atherosclerosis. And its intervention may be an important preventive strategy for intracranial multi-vessel atherosclerosis.

关 键 词：代谢综合征 颅内动脉硬化 动脉粥样硬化 危险因素 

分 类 号：R74[医药卫生—神经病学与精神病学] R589[医药卫生—临床医学]