CISS分型穿支动脉供血区急性单发缺血性脑梗死各亚型前后循环危险因素探讨  

Analysis of risk factors related to the anterior and posterior circulation of each subtype of acute single ischemic cerebral infarction in the perforating artery blood supply area of CISS classification

作　　者：庞萌 张晓俊 王刚[1] 王彬[1] 王炎强[1] PANG Meng;ZHANG Xiaojun;WANG Gang;WANG Bin;WANG Yanqiang(Department of Neurology,the Affiliated Hospital of Weifang Medical University,Weifang 261031,China)

机构地区：[1]潍坊医学院附属医院神经内科,山东潍坊261031

出　　处：《潍坊医学院学报》2021年第4期273-276,共4页Acta Academiae Medicinae Weifang

基　　金：山东省中医药科技发展计划项目资助课题(项目编号:2019-0432);山东省科技发展计划项目资助课题(项目编号:202003070377)。

摘　　要：目的探讨CISS分型穿支动脉供血区单发的急性缺血性卒中(AIS)各亚型前后循环的相关危险因素。方法回顾性纳入AIS患者,记录患者一般资料、检验资料、影像学检查等。根据CISS分型,结合颅脑DWI和MRA提示的梗死部位及病变血管,将患者分为LAA-BAD,PAD-BAD,PAD-LD型,每型分别分为前循环组、后循环组。采用两分类Logistic回归分析各亚型前后循环的独立危险因素。结果纳入264例穿支动脉供血区单发的AIS患者。LAA-BAD型前后循环对比,男性、高血压病、冠心病、LDL-C差异有统计学意义;PAD-BAD型前后循环对比,LDL-C、TC差异有统计学意义;PAD-LD型前后循环对比,LDL-C、Hcy差异有统计学意义。Logistic回归分析示,男性(OR=3.943,95%CI:1.297-11.986,P=0.016)、高血压病(OR=2.691,95%CI:1.005-7.207,P=0.049)、LDL-C(OR=1.792,95%CI:1.024-3.134,P=0.041)是LAA-BAD型后循环可能的独立危险因素;LDL-C(OR=2.564,95%CI:1.274-5.181,P=0.008)是PAD-BAD型后循环可能的独立危险因素;TC(OR=0.450,95%CI:0.254-0.795,P=0.006)是PAD-BAD型前循环可能的独立危险因素;LDL-C(OR=2.123,95%CI:1.145-3.936,P=0.017)是PAD-LD型后循环可能的独立危险因素。结论男性、高血压病、LDLC可能与LAA-BAD型后循环独立相关;LDL-C可能与PAD-BAD型后循环独立相关;TC可能与PAD-BAD型前循环独立相关;LDL-C可能与PAD-LD型后循环独立相关。Objective To investigate the related risk factors of the anterior and posterior circulation of each subtype of acute single ischemic cerebral infarction in the perforating artery area by the CISS classification.Methods Patients with AIS were included retrospectively.The general data,laboratory data,imaging examinations were collected.According to the CISS classification and infarct location and diseased vessels indicated by craniocerebral DWI and MRA,the patients were divided into LAA-BAD,PAD-BAD,PAD-LD type,and anterior or posterior circulation of each subtype.Two-category Logistic regression was used to analyze the independent risk factors of each subtype.Results Two hundred and sixty-four patients with single AIS in the perforating artery blood supply area were enrolled.Compared LAA-BAD anterior circulation with posterior circulation,differences in male,hypertension,coronary heart disease and HbAlc were statistically significant.Compared PAD-BAD anterior circulation with posterior circulation,differences in LDL-C,TC difference were statistically significant.Compared PAD-LD anterior circulation with and posterior circulation,differences in LDL-C and Hcy were statistically significant.Logistic regression analysis showed that males(OR=3.943,95%CI:1.297-11.986,P=0.016),hypertension(OR=2.691,95%CI:1.005-7.207,P=0.049),and LDL-C(OR=1.792,95%CI:1.024-3.134,P=0.041)were possible independent risk factors for LAA-BAD posterior circulation;LDL-C(OR=2.564,95%CI:1.274-5.181,P=0.008)was a possible independent risk factor for PAD-BAD posterior circulation;TC(OR=0.450,95%CI:0.254-0.795,P=0.006)was a possible independent risk factor for PAD-BAD anterior circulation;LDL-C(OR=2.123,95%CI:1.145-3.936,P=0.017)is a possible independent risk factor for PAD-LD posterior circulation.Conclusion Male,hypertension and LDL-C may be independently related to LAA-BAD posterior circulation patients;LDL-C may be independently related to PAD-BAD posterior circulation patients;TC may be independently related to PAD-BAD anterior circulation patie

关 键 词：单发缺血性脑梗死 穿支动脉 亚型 前后循环 危险因素 

分 类 号：R743[医药卫生—神经病学与精神病学]