急性腔隙性脑梗死与颈部动脉狭窄的相关性及危险因素分析(1)
摘 要：目的 探讨急性腔隙性脑梗死与颈部动脉狭窄的关系以及LI发病的危险因素。方法 选取2015年6月～2018年4月在宁波市第二医院神经内科确诊的急性LI患者162例，根据发现的梗死病灶数目分为A组(病灶数目≤3个)115例和B组(病灶数目>3个)47例，记录病灶的位置、数目，同时选取75例阴性患者为对照组，记录颈部动脉狭窄情况，分析急性LI发病与颈部动脉狭窄的相关性，以及患者的年龄、性别、严重心律失常、高血压病、糖尿病、高脂血症、嗜烟、酗酒等因素与LI发病的关系。结果 A组与B组病灶的分布比较，差异无统计学意义(P>0.05)，A组、B组与对照组之间的颈部动脉狭窄率比较，差异有统计学意义(P<0.05)，但狭窄位置差异无统计学意义(P>0.05)。急性LI病灶数量与动脉狭窄程度的Spearman相关系数为0.25(P<0.05)。急性LI发病的独立危险因素是糖尿病(OR=2.391，P<0.05)和嗜烟(OR=2.865，P<0.05)。结论 急性LI病灶数目与颈部动脉狭窄程度存在弱正相关性，有效控制血糖水平、尽早戒烟可能对急性LI的二级预防有利。
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关键词：腔隙性脑梗死；颈部动脉狭窄；糖尿病；嗜烟
中图分类号：R743.3；R543.4 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.23.019
文章编号：1006-1959(2018)23-0067-05
Abstract：Objective To explore the relationship between acute lacunar infarction and carotid artery stenosis and analysis risk factors of LI. Methods A total of 162 patients with acute LI diagnosed in our hospital were selected and divided into group A (number of lesions≤3) 115 cases and group B (number of lesions>3) 47 cases，according to the number of infarcted lesions. The location and number of acute lesions were recorded. 75 case-negative patients were selected as the control group at the same time. Cervical artery stenosis of all subjects was recorded. The correlation between the incidence of acute LI and carotid artery stenosis was analyzed. The risk factors about age， sex， severe arrhythmia， hypertension， diabetes， hyperlipidemia， smoking and alcoholism were analyzed as well. Results There was no statistical difference between the A and B group (P>0.05). There was a significant difference in the stenosis rate between the A， B and the control group (P<0.05)， but the artery stenosis position was not statistically significant (P>0.05)， and the Spearman correlation coefficient between the number of acute LI lesions and the degree of arterial stenosis was 0.25 (P<0.05). The independent risk factors for acute LI were diabetes (OR=2.391，P<0.05) and smoking (OR=2.865，P<0.05). Conclusion There is a weak positive correlation between the number of acute LI lesions and the extent of carotid artery stenosis. Effective control of blood glucose levels and early cessation of smoking may be beneficial for secondary prevention of acute LI.
, 百拇医药
Key words：Lacunar infarction；Carotid artery stenosis；Diabetes；Smoking
腔隙性腦梗死(lacunar infarction，LI)是较常见的脑血管疾病，通常起病较隐匿，短期内功能恢复完全而容易被临床所忽视。近年来，积累的循证医学证据提示LI患者的死亡率、抑郁以及痴呆的发病率随着随访时间延长而逐渐上升[1]。此外，普遍认为LI是因单个穿支小动脉病变引起，大动脉粥样硬化所致的穿支小动脉闭塞常常被忽视。磁共振扩散加权成像(diffusion-weighted imaging，DWI)是目前诊断急性LI的金标准，CT血管造影(CT angiography，CTA)检查便捷快速、安全无创，是评估动脉粥样硬化病变的重要手段[2]。本研究拟通过影像学方法寻找诊急性LI的责任大血管证据，并初步分析急性LI的致病危险因素，为研究疾病的发生发展和二级预防提供一定参考。, http://www.100md.com(戴琦 郑建军 金银华)
, http://www.100md.com
关键词：腔隙性脑梗死；颈部动脉狭窄；糖尿病；嗜烟
中图分类号：R743.3；R543.4 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.23.019
文章编号：1006-1959(2018)23-0067-05
Abstract：Objective To explore the relationship between acute lacunar infarction and carotid artery stenosis and analysis risk factors of LI. Methods A total of 162 patients with acute LI diagnosed in our hospital were selected and divided into group A (number of lesions≤3) 115 cases and group B (number of lesions>3) 47 cases，according to the number of infarcted lesions. The location and number of acute lesions were recorded. 75 case-negative patients were selected as the control group at the same time. Cervical artery stenosis of all subjects was recorded. The correlation between the incidence of acute LI and carotid artery stenosis was analyzed. The risk factors about age， sex， severe arrhythmia， hypertension， diabetes， hyperlipidemia， smoking and alcoholism were analyzed as well. Results There was no statistical difference between the A and B group (P>0.05). There was a significant difference in the stenosis rate between the A， B and the control group (P<0.05)， but the artery stenosis position was not statistically significant (P>0.05)， and the Spearman correlation coefficient between the number of acute LI lesions and the degree of arterial stenosis was 0.25 (P<0.05). The independent risk factors for acute LI were diabetes (OR=2.391，P<0.05) and smoking (OR=2.865，P<0.05). Conclusion There is a weak positive correlation between the number of acute LI lesions and the extent of carotid artery stenosis. Effective control of blood glucose levels and early cessation of smoking may be beneficial for secondary prevention of acute LI.
, 百拇医药
Key words：Lacunar infarction；Carotid artery stenosis；Diabetes；Smoking
腔隙性腦梗死(lacunar infarction，LI)是较常见的脑血管疾病，通常起病较隐匿，短期内功能恢复完全而容易被临床所忽视。近年来，积累的循证医学证据提示LI患者的死亡率、抑郁以及痴呆的发病率随着随访时间延长而逐渐上升[1]。此外，普遍认为LI是因单个穿支小动脉病变引起，大动脉粥样硬化所致的穿支小动脉闭塞常常被忽视。磁共振扩散加权成像(diffusion-weighted imaging，DWI)是目前诊断急性LI的金标准，CT血管造影(CT angiography，CTA)检查便捷快速、安全无创，是评估动脉粥样硬化病变的重要手段[2]。本研究拟通过影像学方法寻找诊急性LI的责任大血管证据，并初步分析急性LI的致病危险因素，为研究疾病的发生发展和二级预防提供一定参考。, http://www.100md.com(戴琦 郑建军 金银华)