基于头颈CTA探讨急性脑梗死患者颅内外动脉狭窄特征与Lp-PLA2的相关性  

To explore the correlation between intracranial and extracranial artery stenosis and Lp-PLA2 in patients with acute cerebral infarction based on head and neckCTA

作　　者：刘明会 张惠英 Liu Minghui;Zhang Huiying(CT Room,the Affiliated Hospital of North China University of Science and Technology,Tangshan 063000,China)

机构地区：[1]华北理工大学附属医院CT室,河北唐山063000

出　　处：《华北理工大学学报（医学版）》2023年第4期265-271,共7页Journal of North China University of Science and Technology：Health Sciences Edition

摘　　要：目的通过对CT血管造影(CTA)图像进行观察分析,探讨急性脑梗死(ACI)患者颅内外动脉狭窄的分布特征,分析脂蛋白相关磷脂酶A2(Lp-PLA2)与动脉狭窄分布的相关性。方法收集2020年10月~2021年11月于我院诊断治疗的ACI患者120例经CTA检查存在颅内外动脉粥样硬化性狭窄,将患者依据动脉狭窄部位、病变供血区及狭窄数量的不同分为不同亚组,分析血清Lp-PLA2与动脉狭窄的相关性。结果120例患者中单纯动脉狭窄75例(62.5%),其中单纯颅内动脉狭窄51例(68.0%)、单纯颅外动脉狭窄24例(32.0%),颅内外并存动脉狭窄45例(37.5%);单纯前循环动脉狭窄51例(42.5%),单纯后循环动脉狭窄27例(22.5%),前后循环并存动脉狭窄42例(35.0%)。单纯颅内动脉狭窄组Lp-PLA2水平明显高于单纯颅外及颅内外并存动脉狭窄组,差异有统计学意义(P<0.05),三类不同循环区域病变组间患者Lp-PLA2水平差异无统计学意义(P>0.05);多支动脉狭窄组Lp-PLA2水平明显高于单支组(P<0.05);多因素Logistic回归分析提示,Lp-PLA2是单纯颅内动脉狭窄的危险因素(OR=1.031,P<0.05)。结论ACI颅内动脉狭窄发生率高于颅外动脉狭窄,前循环狭窄多于后循环狭窄;血清Lp-PLA2水平是单纯颅内动脉粥样硬化狭窄的独立预测因素;且随着狭窄动脉支数的增加,Lp-PLA2水平逐渐升高;但血清Lp-PLA2对动脉狭窄处于前循环还是后循环区域并无明显影响。Objective In this study the distribution characteristics of stenosis in patients with acute cerebral infarction and the effect of serum lipoprotein-associated phospholipase A2(Lp-PLA2)on the characteristics of arterial stenosis were investigated by observational analysis of CT angiography(CTA)images of patients participating.Methods A total of 120 patients with acute cerebral infarction who were admitted to our hospital for diagnosis and treatment from October 2020 to November 2021 with intracranial atherosclerotic stenosis on CTA examination were collected,and they were divided into distinct groups,and the correlation between Lp-PLA2 and intracranial and extracranial stenosis was observed and analyzed.Results In 120 patients,there were 75 cases(62.5%)of single arterial stenosis,including 51 cases(68.0%)of simple intracranial stenosis,24 cases(32.0%)of simple extracranial stenosis,and 45 cases of coexisting stenosis of internal and external arteries(37.5%).51 cases(42.5%)of simple anterior circulation stenosis,27 cases(22.5%)of simple posterior circulation stenosis,and 42 cases of coexisting stenosis of anteroposterior circulation(35.0%).The Lp-PLA2 level was higher in isolated intracranial stenosis than isolated extracranial stenosis and extracranial and extracranial coexistence stenosis,the difference was statistically significant(P<0.05);There was no significant difference in Lp-PLA2 levels among the three groups with different circulatory lesions(P>0.05);Lp-PLA2 level was higher in the multi-vessel vessel stenosis than in the single vascular vessel stenosis group(P<0.05);And logistic regression analysis suggested that Lp-PLA2 was a risk factor for intracranial artery stenosis(OR=1.031,P<0.05).Conclusion The incidence of intracranial artery stenosis in acute cerebral infarction is higher than that of extracranial artery stenosis,and anterior circulation stenosis is more than posterior circulation stenosis.Serum Lp-PLA2 level is an independent risk factor for intracranial atherosclerotic stenosis;And with the i

关 键 词：急性脑梗死 颅内外动脉狭窄 脂蛋白相关磷脂酶A2 CTA 

分 类 号：R743.33[医药卫生—神经病学与精神病学]