大血管闭塞性卒中病人脑白质高信号严重程度与侧支循环的关系  

Correlation between the severity of white matter hyperintensity and collateral circulation in patients with large-vessel occlusive stroke

作　　者：冯凡凡 杨洪超 阚伟豪 董瑞国 FENG Fanfan;YANG Hongchao;KAN Weihao;DONG Ruiguo(The First Clinical College of Xuzhou Medical University,Xuzhou,Jiangsu 221004,China;Department of Neurology,The Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221000,China.)

机构地区：[1]徐州医科大学第一临床医学院,江苏徐州221004 [2]徐州医科大学附属医院神经内科,江苏徐州221000

出　　处：《安徽医药》2024年第6期1176-1181,共6页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨急性前循环大血管闭塞性卒中病人的脑白质高信号(WMHs)严重程度与侧支循环状况的关系。方法回顾性纳入2017年5月至2022年7月徐州医科大学附属医院收治的前循环大血管闭塞并接受血管内机械性血栓切除术治疗的急性缺血性脑卒中病人。根据美国介入和治疗神经放射学学会/介入放射学学会(ASITN/SIR)侧支循环分级系统将病人分为侧支循环良好及侧支循环不良两组,并采用Fazekas评分量表评估WMHs严重程度。采用多因素logistic回归分析探索WMHs与前循环大血管闭塞性卒中病人侧支循环的关系。结果共纳入127例前循环大血管闭塞性卒中病人,年龄(62.24±13.63)岁,其中侧支循环良好组56例,侧支循环不良组71例。单因素分析显示侧支循环不良组美国国立卫生研究院卒中量表(NIHSS)评分[16.00(11.00,21.00)分]、脑室旁脑白质高信号(PWMHs)评分[2.00(1.00,2.00)分]、深部脑白质高信号(DWMHs)评分[2.00(1.00,2.00)分]以及总的脑白质高信号(TWMHs)评分[3.00(3.00,4.00)分]高于侧支循环良好组[12.00(10.00,17.75)分、1.00(1.00,2.00)分、1.00(1.00,2.00)分](P<0.05)。多因素logistic回归分析显示,PWMHs评分[OR=1.79,95%CI:(1.10,2.90),P=0.019]及DWMHs评分[OR=1.63,95%CI:(1.05,2.55),P=0.031]是侧支循环不良的危险因素。结论在急性前循环大血管闭塞性卒中病人中,WMHs的严重程度与侧支循环不良有关。Objective To investigate the correlation between white matter hyperintensity(WMH)severity and collateral circulation status in patients with acute anterior circulation large vessel occlusive stroke.Methods This retrospective study included patients with acute ischemic stroke admitted to the Affiliated Hospital of Xuzhou Medical University from May 2017 to July 2022 with large vessel occlusion of the anterior circulation who were treated with endovascular mechanical thrombectomy.Patients were divided into two groups according to the American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology(ASITN/SIR)collateral circulation grading system with good collateral circulation and poor collateral circulation,and the severity of WMHs was assessed using the Fazekas Rating Scale.Multivariate logistic regression analysis was used to explore the correlation between WMHs and collateral circulation in patients with anterior circulation large vessel occlusive stroke.Results A total of 127 patients with anterior circulation large vessel occlusive stroke were included at the age of(62.24±13.63)years,including 56 patients in the good collateral circulation group and 71 patients in the poor collateral circulation group.Univariate analysis revealed that the National Institutes of Health Stroke Scale(NIHSS)score[16.00(11.00,21.00)points],paraventricular cerebral white matter high signals(PWMHs)score[2.00(1.00,2.00)points],deep cerebral white matter high signals(DWMHs)score[2.00(1.00,2.00)points]in the poor collateral circulation group and total cerebral white matter high signals(TWMHs)score[3.00(3.00,4.00)points]were greater than those in the group with good collateral circulation[12.00(10.00,17.75)points,1.00(1.00,2.00)points,1.00(1.00,2.00)points](P<0.05).Multivariate logistic regression analysis revealed that the PWMHs score[OR=1.79,95%CI:(1.10,2.90),P=0.019]and DWMHs score[OR=1.63,95%CI:(1.05,2.55),P=0.031]were risk factors for collateral circulation malpractice.Conclusion In patients wi

关 键 词：卒中 大血管闭塞性卒中 脑白质高信号 侧支循环 磁共振成像 数字减影脑血管造影 

分 类 号：R743.3[医药卫生—神经病学与精神病学]