动脉粥样硬化性颈内动脉狭窄与脑白质高信号关系分析  

Association between atherosclerotic internal carotid artery stenosis and white matter hyperintensity

作　　者：叶慧茸 王玉洁[1] 仇建婷 王健[1] 武青 徐萌萌 Ye Huirong;Wang Yujie;Qiu Jianting;Wang Jian;Wu Qing;Xu Mengmeng(Department of Neurology,Liaoning provincial People＇s Hospital,Shenyang 110016,Liaoning Province,China)

机构地区：[1]辽宁省人民医院神经内科,沈阳110016

出　　处：《中华老年心脑血管病杂志》2018年第9期949-952,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：辽宁省自然科学基金(20170540531)

摘　　要：目的分析动脉粥样硬化性颈内动脉(internal carotid artery,ICA)狭窄与脑白质高信号(white matter hyperintensity,WMH)的关系。方法入选一侧颅内或颅外ICA狭窄≥70%、对侧ICA狭窄<50%患者115例,根据ICA狭窄同侧分布区内是否有急性脑梗死或陈旧性脑梗死分为脑梗死组61例和非脑梗死组54例。分别记录双侧大脑半球皮质下和脑室周围WMH评分,比较2组狭窄同侧WMH评分、所有ICA狭窄患者狭窄同侧和对侧WMH评分。结果脑梗死组与非脑梗死组狭窄同侧皮质下WMH评分[2(1,3)分vs 1(0,3)分,P=0.201]和脑室周围WMH评分比较无显著差异[1(1,2)分vs 1(1,2)分,P=0.672]。ICA狭窄同侧皮质下WMH评分(OR=3.956,95%CI:1.606~9.745,P=0.003)和脑室周围WMH评分(OR=3.366,95%CI:1.477~7.671,P=0.004)显著高于对侧。结论 ICA狭窄≥70%同侧皮质下WMH评分和脑室周围WMH评分为狭窄对侧的3~4倍,不伴发脑梗死与伴发脑梗死的ICA狭窄患者狭窄同侧WMH评分无差异。Objective To analyze the association between atherosclerotic internal carotid artery（ICA）stenosis and white matter hyperintensity（WMH）.Methods One hundred and fifteen patients with their ipsilateral ICA stenosis≥70% and their contralateral ICA stenosis50% were divided into cerebral infarction（CI）group（n=61）and CI-free group（n=54）according to the presentation of ipsilateral acute or old CI.Their bilateral subcortical and periventricular WMH scores,and their ipsilateral and contralateral WMH scores were recorded and compared.ResultsNo significant difference was found in subcortical and periventricular WMH scores between the two groups[2（1,3）vs 1（0,3）,P=0.201;1（1,2）vs 1（1,2）,P=0.672].The subcortical and periventricular WMH scores of ipsilateral ICA stenosis were significantly higher than those of contralateral ICA stenosis（OR=3.956,95%CI：1.606-9.745,P=0.003;OR=3.366,95%CI：1.477-7.671,P=0.004）.Conclusion Subcortical and periventricular WMH scores of ipsilateral ICA stenosis≥70% are 3-4 times as high as those of contralateral ICA stenosis50%.However,no significant difference in ipsilateral WMH score is found in ICA stenosis patients with or without CI.

关 键 词：动脉粥样硬化 颈动脉狭窄 脑梗死 脑白质高信号 

分 类 号：R743.3[医药卫生—神经病学与精神病学]