腔隙性卒中合并颅内动脉狭窄的危险因素研究  

Study of the risk factors of intracranial artery stenosis in lacunar infarction patients

作　　者：米军辉 刘志奇[2] 张斌 刘欣 张雪萍[3] 

机构地区：[1]河北省无极县医院重症医学科,052460 [2]石家庄市第一医院麻醉科,050011 [3]河北省胸科医院重症医学科,石家庄市050041

出　　处：《临床合理用药杂志》2015年第23期18-20,共3页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的探讨腔隙性卒中合并颅内动脉狭窄的危险因素。方法回顾性收集、比较腔隙型脑梗死患者的人口统计学和临床资料,确定腔隙性脑梗死患者合并颅内动脉狭窄的独立危险因素。结果共纳入198例腔隙性脑梗死患者,平均年龄（63.89±11.17）岁,颅内动脉狭窄组121例（67.7%）,其中单发性动脉狭窄29例（24.0%）,多发性动脉狭窄92例（76.0%）。198例腔隙性脑梗死患者当中,合并高血压病120例（60.6%）,高脂血症98例（49.5%）,冠心病62例（31.3%）。颅内动脉狭窄组冠心病（42.1%vs.14.3%;χ^2=9.205,P=0.002）和糖尿病（25.6%vs.10.4%;χ^2=3.173,P=0.007）以及颈动脉IMT增厚（29.7%vs.7.8%;χ^2=3.962,P=0.047）的患者比例显著高于无颅内动脉狭窄组,高密度脂蛋白胆固醇（HDL-C）水平显著性低于无颅内动脉狭窄组[（1.31±0.52）mmol/L vs.（1.57±1.54）mmol/L;t=-2.242,P=0.026]。多变量Lolgistic回归分析显示,冠心病[优势比（OR）10.013,95%可信区间（CI）1.079~92.900;P=0.043]和糖尿病（OR 6.766,95%CI 1.704~26.870,P=0.006）是腔隙性梗死患者的颅内动脉狭窄的危险因素,而HDL水平较高（OR=0.015,95%CI=0.001-0.299）是腔隙性梗死患者合并颅内动脉狭窄的保护性因素。结论腔隙性脑梗死患者多合并颅内动脉狭窄,冠心病和糖尿病是腔隙性梗死合并颅内动脉狭窄的独立危险因素。Objective To analysis the risk factors of intracranial artery stenosis in lacunar infarction patients. Meth- ods Retrospectively compare the clinical data of patients with lacunar infarction and to identify the independent risk factors of lacunar cerebral infarction complicated with intracranial artery stenosis. Results There were 198 patients with lacunar infarc- tion. The average age was （63.89 ±11.17）years old. Intracranial artery stenosis group were 121 cases （67.7%） ,29 cases （24%） were the solitary artery stenosis,92 cases （76%） were multiple artery stenosis. And 120 eases（ 120/174,60.6% ） with hypertension,98 cases（98/174,49.5% ） with hyperlipemia,62 cases（62/174,31.3% ） with coronary disease. Coronary heart disease （42.1% vs. 14.3% ; x^2 = 9. 205, P = 0. 002） and diabetes mellitus （ 25.6% vs. 10.4% ; x^2 = 3. 173, P = 0. 007） and carotid IMT thickening （29.7% vs. 7.8% ;x^2 = 3. 962, P = 0.047） was significantly higher in intraeranial artery stenosis group than that in the patients without intracranial artery stenosis group. High density lipoprotein cholesterol （HDL- C） level was significantly lower than the no intracranial artery stenosis group [ （ 1.31 ± 0.52） mmol/L vs. （ 1.57± 1.54） mmol/L;t = -2.242,P = 0.026 ]. Multivariate lolgistic regression analysis showed that coronary heart disease （OR 10.013, 95 % CI 1. 079 ±92. 900 ; P = 0. 043 ] ） and diabetes mellitus （ OR 6. 766,95 % CI 1. 704 ± 26.870, P = 0.006） were risk fac- tors of intracranial artery in patients with lacunar infarction narrow narrow. And higher levels of HDL （ OR =0.015,95% CI = 0.001 -0.299） were the protective factors of intracranial artery stenosis in patients with lacunar infarction. Conclusion It is common with lacunar cerebral infarction patients with intracranial artery stenosis. Coronary heart disease and diabetes are inde- pendent risk factors of intracranial arterial stenosis associated with lacunar infarction.

关 键 词：腔隙性脑梗死 颅内动脉狭窄 危险因素 

分 类 号：R743.33[医药卫生—神经病学与精神病学]