脑小血管病总体负担与缺血性卒中复发的相关性研究  

Relationship between total burden of cerebral small vessel disease and recurrent ischemic stroke

作　　者：杨晓雨[1] 苏宸 王瑶[1] 赵仁亮[1] YANG Xiaoyu;SU Chen;WANG Yao(Department of Neurology,the Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院神经内科,山东青岛266003

出　　处：《中风与神经疾病杂志》2023年第8期723-729,共7页Journal of Apoplexy and Nervous Diseases

摘　　要：目的探讨脑小血管病(cerebral small vessel diseases,CSVD)总体负担与复发性缺血性卒中的关系。方法收集2019年6月-2020年12月期间住院的临床资料完整的704例急性缺血性卒中患者,对其行CSVD总体负担评分。随访90 d、1年,根据有无卒中复发分为复发组和未复发组,比较两组患者临床资料及影像学资料之间的差异,通过Logistic回归分析复发缺血性卒中的危险因素,通过计算受试者工作特征(ROC)曲线下面积来探索CSVD总体负担对卒中复发的预测价值。结果随访90 d时,复发组25例(3.55%),未复发组679例(96.45%),两组在年龄、规律服用抗血小板药物情况、脑动脉狭窄、CSVD总体负担、WMH、CMB、腔隙方面均有统计学差异,Logistic回归分析示脑动脉狭窄、CSVD总体负担是卒中复发独立危险因素,规律服用抗血小板药物是其保护因素;随访1年时,复发组100例(14.20%),未复发组604例(85.80%),两组在年龄、高血压、糖尿病、空腹血糖、服用抗血小板药物情况、服用调脂药物、脑动脉狭窄、CSVD总体负担、WMH、CMB、腔隙方面均有统计学差异,Logistic回归分析显示高血压、糖尿病、脑动脉狭窄、CSVD总体负担、WMH、CMB是卒中复发的独立危险因素,规律服用抗血小板药物是其独立保护因素;ROC曲线结果示:随访90 d AUC=0.823;随访1年,AUC=0.746,CSVD总体负担对90 d、1年卒中复发具有一定的预测价值。结论CSVD总体负担与复发缺血性卒中存在相关性,CSVD总体负担是复发性缺血性卒中的独立危险因素,可作为未来缺血性卒中复发的预测指标。Objective To investigate the relationship between the total burden of cerebral small vessel diseases(CSVD)and recurrent ischemic stroke.Methods We included 704 patients with acute ischemic stroke with complete clinical data admitted to our hospital from June 2019 to December 2020.They were scored for the total CSVD burden.After follow-ups of 90 days and one year,they were divided into recurrence group and non-recurrence group according to whether there was a recurrent ischemic stroke.The clinical data and imaging data of the two groups were compared.The risk factors for recurrent ischemic stroke were determined by Logistic regression analysis.The predictive value of the total CSVD burden for stroke recurrence was evaluated using the area under the receiver operating characteristic curve(AUC).Results At the 90-day follow-up,there were 25(3.55%)cases in the recurrence group and 679(96.45%)cases in the non-recurrence group.The two groups differed significantly in age,the use of antiplatelet drugs,cerebral artery stenosis,total CSVD burden,white matter hyperintensities(WMH),cerebral microbleeds(CMB),and lacunes.The Logistic regression analysis showed that cerebral artery stenosis and the total CSVD burden were independent risk factors for recurrent ischemic stroke,while the use of antiplatelet drugs was an independent protective factor against stroke recurrence.At the one-year follow-up,there were 100(14.20%)cases in the recurrence group and 604(85.80%)cases in the non-recurrence group,with significant differences in age,hypertension,diabetes,fasting blood glucose level,the use of antiplatelet drugs,the use of lipid-regulating drugs,cerebral artery stenosis,the total CSVD burden,WMH,CMB,and lacunes.The Logistic regression analysis showed that the independent risk factors for stroke recurrence included hypertension,diabetes,cerebral artery stenosis,the total CSVD burden,WMH,and CMB,while the use of antiplatelet drugs was the independent protective factor.The AUC of the total CSVD burden was 0.823 at the 90-day follow-

关 键 词：总体负担 脑小血管病 复发性卒中 

分 类 号：R743[医药卫生—神经病学与精神病学]