颈动脉钙化模式与急性脑梗死患者短期预后的相关研究  

Association between the pattern of carotid artery calcification and the short-term prognosis of patients with acute cerebral infarction

作　　者：王建伟[1] 姚余 张美霞 陈红芳 傅亚明 WANG Jianwei;YAO Yu;ZHANG Meixia(Department of Neurology,Affiliated Jinhua Hospi-tal,Zhejiang University School of Medicine,Jinhua 321000,China)

机构地区：[1]浙江大学医学院附属金华医院神经内科,浙江金华321000

出　　处：《中风与神经疾病杂志》2025年第1期38-41,共4页Journal of Apoplexy and Nervous Diseases

基　　金：浙江省医药卫生科技计划项目(2023KY380);金华市科技计划项目(2020-3-026);金华市中心医院基础研究专项科研基金(JY2021-7-09)。

摘　　要：目的 探讨颈动脉的钙化模式与急性脑梗死患者治疗3个月的预后相关性。方法 纳入2021年3月—2022年9月就诊于浙江大学医学院附属金华医院的急性缺血性脑卒中(AIS)患者112例为研究对象,入院24h完成头部CT血管成像,评估颈动脉的钙化模式(无钙化、内膜钙化和中膜钙化)以及钙化负荷(低和高钙化)。治疗7 d复查头部CT评估出血转化和梗死体积,随访3个月根据改良Rankin评分(mRS)分为预后良好组82例(<3分)和不良组30例(≥3分)。结果 不良组年龄≥70岁、平均收缩压≥165 mmHg、空腹血糖≥7.5 mmol/L、入院NIHSS评分≥12分、内膜钙化和中膜钙化、高钙化、出血转化以及梗死体积≥50 mm3显著高于良好组(P<0.05)。多因素Logistic回归显示,入院NIHSS评分≥12分、内膜钙化、出血转化以及梗死体积≥50 mm3是预后不良的危险因素(P<0.05)。结论 AIS患者颈动脉的内膜钙化可能与短期预后不良有关,可作为预后评估的新型无创性指标。Objective To investigate the association between the pattern of carotid artery calcification and the prognosis of patients with acute cerebral infarction after 3 months of treatment.Methods A total of 112 patients who were diagnosed with acute ischemic stroke(AIS)in our hospital from March 2021 to September 2022 were enrolled as subjects.CT angiography was performed within 24 hours after admission,and the carotid artery was assessed in terms of calcification pattern(no calcification,intimal calcification,and medial calcification)and calcification load(low and high calcification).After 7 days of treatment,CT reexamination was performed to evaluate hemorrhagic transformation and infarct volume.The patients were followed up for 3 months,and according to the modified Rankin Scale(mRS)score,they were divided into good prognosis group(82 patients with an mRS score of<3 points)and poor prognosis group(30 patients with an mRS score of≥3 points).Results Compared with the good prognosis group,the poor prognosis group had a significantly higher proportion of patients with an age of≥70 years,a mean systolic blood pressure of≥165 mmHg,a fasting blood glucose level of≥7.5 mmol/L,an NIHSS score of≥12 on admission,intimal calcification,medial calcification,high calcification,hemorrhagic transformation,and an infarct volume of≥50 mm3(P<0.05).The multivariate logistic regression analysis showed that NIHSS score≥12 on admission,intimal calcification,hemorrhagic transformation,and infarct volume≥50 mm3 were risk factors for poor prognosis(P<0.05).Conclusion Intimal calcification of the carotid artery may be associated with the poor short-term prognosis of AIS patients,which can be used as a new noninvasive indicator for predicting prognosis.

关 键 词：急性脑梗死 颈动脉钙化 预后 出血转化 内膜钙化 

分 类 号：R743.33[医药卫生—神经病学与精神病学]