动脉粥样硬化性颈内动脉狭窄与缺血性脑损伤的相关性分析  

Relationship between atherosclerotic internal carotid artery stenosis and ischemic brain injury

作　　者：仇建婷 王玉洁[1] 梁彩虹 王健[1] Qiu Jianting;Wang Yujie;Liang Caihong;Wang Jian(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

出　　处：《中华老年心脑血管病杂志》2019年第12期1241-1244,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨动脉粥样硬化性颈内动脉(ICA)狭窄与缺血性脑损伤的关系。方法回顾性分析我院神经内科住院治疗的单侧ICA狭窄≥70%的患者117例。收集其一般情况及影像资料,进行脑白质高信号(WMH)评分、液体衰减反转恢复(FLAIR)血管高信号(FVH)评分和前循环颅内段血管狭窄评分(SSA),比较ICA狭窄同侧及对侧缺血性脑损伤的影像资料。结果狭窄同侧陈旧性腔隙性脑梗死评分和血管周围间隙比例与对侧比较,无统计学差异(P>0.05)。狭窄同侧脑梗死、新发脑梗死、陈旧性脑梗死、WMH评分、FVH评分明显高于对侧,SSA明显低于对侧,差异有统计学意义[54.70%vs 12.82%,P=0.000;47.86%vs 6.84%,P=0.000;18.80%vs 6.84%,P=0.011;3(1,5)分vs 2(1,3)分,P=0.000;1(0,4)分vs 0分,P=0.000;7(3,9)分vs 10(9,10)分,P=0.000]。多因素logistic回归分析显示,ICA狭窄同侧新发脑梗死、WMH评分、FVH评分和SSA与ICA狭窄独立相关(P<0.05,P<0.01)。结论动脉粥样硬化性ICA狭窄与新发脑梗死、WMH、FVH及SSA相关。Objective To study the relationship between atherosclerotic internal carotid artery(ICA)stenosis and ischemic brain injury.Methods One hundred and seventeen unilateral ICA stenosis(≥70%)patients admitted to our hospital from April 2016 to December 2017 were included in this study.Their general and imaging data,white matter hyperintensity(WMH)score,FLAIR vascular hyperintensity score and anterior circulation intracranial artery(ACIA)stenosis score were retrospectively analyzed.The imaging data of their homolateral ICA stenosis and bilateral ischemic brain injury were compared.Results No significant difference was detected in homolateral old lacunar infarction score and perivascular space ratio between homolateral ICA stenosis and contralateral ICA stenosis(P>0.05).The incidence of cerebral infarction,new and old cerebral infarction,WMH and FLAIR vascular hyperintensity scores were significantly higher while the atherosclerotic CIA score was significantly lower in homolateral ICA stenosis than in contralateral ICA stenosis[54.70%vs 12.82%,P=0.000;47.86%vs 6.84%,P=0.000;18.80%vs 6.84%,P=0.011;3(1,5)vs 2(1,3),P=0.000;1(0,4)vs 0,P=0.000;7(3,9)vs 10(9,10),P=0.000].Multivariate logistic regression analysis showed that ICA stenosis was independently related with new cerebral infarction,WMH core,FLAIR vascular hyperintensity score and atherosclerotic CIA stenosis score(P<0.05,P<0.01).Conclusion Atherosclerotic ICA stenosis is related with new cerebral infarction,WMH,FLAIR vascular hyperintensity and ACIA score.

关 键 词：动脉粥样硬化 颈动脉狭窄 脑梗死 脑缺血 高半胱氨酸 

分 类 号：R74[医药卫生—神经病学与精神病学]