症状性颅内动脉狭窄患者的缺血事件复发及其危险因素  

Outcome and risk factors of patients with symptomatic intracranial atherosclerotic stenosis

作　　者：王普清[1] 王安平[1] 曹治华[1] 王璞[1] 陈华先[1] 宋金辉[1] 黄瓅[1] 周佩洋[1] 王守安[1] 王勇[2] 

机构地区：[1]湖北医药学院附属襄阳医院神经科,湖北441000 [2]湖北医药学院附属襄阳医院CT室,湖北441000

出　　处：《脑与神经疾病杂志》2013年第5期330-333,共4页Journal of Brain and Nervous Diseases

基　　金：湖北省卫生厅科研基金项目(JX4B64);襄阳市科技局科研基金项目(2012-132)

摘　　要：目的探讨症状性颅内动脉狭窄患者的缺血事件复发和危险因素。方法连续登记神经科住院的急性脑梗死或TIA患者,CTA检查发现颅内动脉主干狭窄患者入组;对入组患者进行定期随访,按有无脑血管事件复发分为复发组和未复发组。主要观察指标:(1)终点事件的发生情况;(2)责任动脉供血区新的卒中;(3)服药依从性。结果符合入选标准的颅内动脉狭窄患者142例,121例(85.2%)完成随访,1年内缺血性脑血管事件发生16例(13.2%),其中12例(75%)复发位于病变血管同侧。单因素分析显示:未规律服用他汀类药(P=0.017)、糖尿病(P=0.017)和动脉重度狭窄(P=0.030)在复发组和未复发组差异有统计学意义。Logistic回归分析发现未规律服用他汀类药物(OR=3.719,P=0.005)、糖尿病(OR=1.842,P=0.029)和动脉重度狭窄(OR=1.503,P=0.045)与症状性颅内动脉狭窄脑卒中复发明显相关。结论症状性颅内动脉狭窄患者脑卒中复发率较高;有糖尿病、动脉重度狭窄和未规律服用他汀类药的颅内动脉狭窄患者有更高的卒中复发风险。Objective To investigate outcome and risk factors of patients with symptomatic intracranial atherosclerotic stenosis.Methods We registrated continuously patients with acute cerebral infarction or transient ischemia attach （TIA） from the department of neurology who had intracranial arterial stenosis confirmed by 64 slices CT angiography （CTA）.All cases were followed-up.Incidence rate of stroke,overdose compliance,influence factors were analyzed.Results 142 cases with intracranied arterial stenosis were registered.121 cases （85.2%） completed the follow-up.Ischemic stroke events occurred in 16 patients （13.2%） in one year.12 cases （75%） located in the ipsilateral recurrence of vascular lesions.Single factor analysis showed that irregular use of statins （P =0.017）,diabetes（P =0.017） and arterial severe stenosis （P =0.030） were a statistically significant difference between the recurrent group and irrecurrent group.Multi-factors Logistic regression suggested that irregular use of statins（OR=3.719,P =0.005）,diabetes（OR=1.842,P =0.029） and arterial severe stenosis（OR=1.503,P =0.045） were related with stroke recurrence.Conclusion There is a higher subsequent rate of stroke in patients with symptomatic intracranial atherosclerotic stenosis.The patients with irregular use of statins,diabetes and arterial severe stenosis had higher subsequent risk of stroke.

关 键 词：症状性颅内动脉狭窄 预后 危险因素 

分 类 号：R743[医药卫生—神经病学与精神病学] R32[医药卫生—临床医学]