缺血性卒中住院患者年龄特征与头颈部大动脉病变分布的多中心研究结果分析  

Age characteristics and distribution of cerivocerebral large artery lesions in inpatients with cerebral ischemia: an analysis of multi-center research results

作　　者：李娜[1] 华扬[1] 贾凌云[1] 邢英琦[2] 惠品晶[3] 孟璇[4] 于德林[5] 潘晓芳[6] 房亚兰[7] 宋彬彬[8] 吴春霞[9] 张春梅[10] 隋秀芳[11] 金友贺[12] 张京芬[13] 李建卫[14] 王凌[15] 穆玉明[16] 钟经馨[17] 朱榆红[18] 张恒[19] 蔡晓宇[20] Li Na Hua Yang Jia Lingyun Xing Yingqi Hui Pinjing Meng Xuan Yu Delin Pan Xiaofang Fang Yalan Song Binbin Wu Chunxia Zhang Chunmei Sui Xiufang Jin Youhe Zhang Jingfen Li Jianwei Wang Ling Mu Yuming Zhong Jingxin Zhu Yuhong Zhang Heng Cai Xiaoyu(Department of Vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, Beijing 100053, China)

机构地区：[1]首都医科大学宣武医院血管超声科,北京100053 [2]吉林大学第一医院神经内科 [3]苏州大学附属第一医院超声科 [4]兰州大学第二医院超声科 [5]天津市环湖医院超声科 [6]大连市中心医院超声科 [7]山西医科大学第一医院超声科 [8]洛阳市中心医院神经内科 [9]山东省聊城市人民医院脑科医院超声科 [10]哈尔滨医科大学附属第一医院超声科 [11]安徽省立医院超声科 [12]中国医科大学附属第一医院超声科 [13]包头市中心医院神经内科 [14]福建省立医院超声科 [15]绵阳市中心医院超声科 [16]新疆医科大学第一附属医院超声科 [17]广东省中医院超声科 [18]昆明医科大学第二附属医院神经内科 [19]珠海市人民医院超声科 [20]湖南省脑科医院超声科

出　　处：《中国脑血管病杂志》2017年第6期285-291,共7页Chinese Journal of Cerebrovascular Diseases

基　　金：基金项目:国家卫生计生委脑卒中筛查与防治工程委员会[血管超声对短暂性脑缺血发作(TIA)与缺血性脑卒中住院患者颅内外动脉病变的多中心检查登记研究(201501)]

摘　　要：目的探讨不同年龄段缺血性脑血管病患者脑大动脉病变分布特点及危险因素的差异,为不同年龄段卒中的防治提供依据。方法连续性纳入2015年6月至2016年5月全国20家中心因短暂性脑缺血发作(TIA)与缺血性卒中住院患者共10 711例,从40岁起始,以每10岁为一年龄段将所有患者分为5个年龄段,比较不同年龄段间脑血管病危险因素差异。再将所有患者按性别分开,应用趋势卡方检验比较同一性别不同年龄段患者颅内、外及前、后循环大动脉狭窄的发生率和血管病变支数。结果 (1)老年患者危险因素以高血压、糖尿病、心房颤动居多(χ~2值分别为61.938、13.349、55.940,均P<0.01);中青年吸烟史、脑血管病家族史及肥胖者居多(χ~2值分别为131.505、7.298、100.911,均P<0.01)。(2)线性趋势卡方检验结果显示,随年龄增长,女性、男性颅外动脉病变中多支血管病变所占的比例均逐渐增加(χ~2值分别为54.799、161.370,均P<0.01);女性患者颅内动脉多支血管病变所占比例逐渐下降(χ~2=5.328,P=0.021),而男性患者颅内动脉病变中多支血管狭窄所占的比例无明显变化趋势(χ~2=0.289,P=0.591)。(3)线性趋势卡方检验结果显示,随年龄增长,女性、男性单纯颅内动脉狭窄发生率均逐渐减少(χ~2=20.090;χ~2=42.351,均P<0.01),单纯颅外动脉狭窄发生率均逐渐升高(χ~2=40.311;χ~2=90.698,均P<0.01),颅内外动脉均存在狭窄的发生率逐渐升高(χ~2=12.077,P=0.001;χ~2=45.887,P<0.01);女性单纯后循环血管狭窄发生率逐渐升高(χ~2=16.434,P<0.01),男性单纯后循环血管狭窄发生率无变化趋势(χ~2=1.701,P=0.192),女性、男性前后循环动脉均狭窄的发生率逐渐升高(χ~2=4.587,P=0.032;χ~2=35.156,P<0.01)。结论不同年龄段缺血性脑血管病患者动脉粥样硬化病变分布存在差异,不论女性还是男性,中青年患者主要为颅内动脉病变,老年患者主要为颅外动脉病变,女性老年患Objective To investigate the differences of distribution characteristics and risk factors of large artery lesions in patients with ischemic cerebrovascular disease in different age groups in order to provide the basis for the prevention and treatment of stroke in different age groups. Methods From June 2015 to May 2016, a total of 10 711 consecutive inpatients with transient ischemic attack （TIA） and ischemic stroke from 20 centers nationwide were enrolled. Each 10 years was used as an age group from 40 years. All the patients were divided into 5 age groups. The differences of the different risk factors for cerebrovascular disease among the 5 groups were compared. All patients were separated by gender. The chi square test was used to compare the incidences of large artery stenosis of the intracranial and external and anterior and posterior circulation, and the number of vascular lesions in the same sex in different age groups. Results （ 1 ） The risk factors of elderly patients were mainly hypertension,diabetes mellitus, and atrial fibrillation （X^2 = 61. 938 ,X^2 = 13. 349, and X^2 = 55. 940 ; all P 〈 0.01 ）. The smoking history, family history of cerebrovascular disease, and obesity were more frequent among the young and middle-aged people （X^2 = 131. 505 ,X^2 =7. 298 ,andX^2 = 100.911 ,all P 〈0.01 ）. （2） The linear trend chi square test results showed that the proportion of multivessel diseases in female and male extracranial arterial lesions increased gradually with the increase of age. （X^2 = 54.799,X^2 = 161. 370, all P 〈 0.01 ）. The proportion of multivessel diseases in the intracranial artery in female decreased gradually （X^2 =5. 328 ,P =0. 021 ）,and that in male did not have obvious trend of change （X^2 = 0. 289,P = 0. 591 ）. （3） The linear trend chi square test results showed that the incidence of simple intracranial arterial stenosis in female and male intracranial arterial stenosis decreased gradually with the increase of age （X^2 = 20. 090 ,X^2 = 42. 351 ,

关 键 词：卒中 年龄 动脉狭窄 分布 超声 

分 类 号：R445.1[医药卫生—影像医学与核医学] R743.3[医药卫生—诊断学]