| 摘要: |
| 目的 探讨脑梗死伴颅内动脉粥样硬化性狭窄的影响因素。 方法 选取脑梗死住院患者 464 例，根据头颅 MRA 和 颈部 CEMRA 结果分为单纯颅内动脉狭窄（ICAS）组 199 例、单纯颅外动脉狭窄（ECAS）组 47 例、颅内合并颅外动脉狭窄（IECAS）组 113 例和无颅内颅外动脉狭窄（NCAS）组 105 例；其中 ICAS 组颅内动脉狭窄率≥50% 135 例、＜50% 64 例。测定与比较以上 4 组患 者间血清 TG、TC、LDL-C、HDL-C、载脂蛋白 B（apoB）、载脂蛋白 A1（apoA1）、尿酸（UA）和同型半胱氨酸（Hcy）等指标的差异，采用 单因素分析和多因素 logistic 回归分析脑梗死伴颅内动脉粥样硬化性狭窄的影响因素。 结果 以上 4 组患者平均年龄，高血压、糖尿 病患病情况，TC、LDL-C 水平，apoA1、apoB、apoB/apoA 方面比较，差异均有统计学意义（均 P＜0.05）。颅内外动脉狭窄分布显示，颅 外血管病变以颈内动脉颅外段和椎动脉颅外段为主，颅内动脉病变以大脑中动脉和颈内动脉颅内段为主。多支颅内动脉狭窄患者的 apoB 水平明显高于单支颅内动脉狭窄患者（P＜0.05）。apoB（OR=8.821）、apoB/apoA1（OR=10.149）和吸烟（OR=2.093）是脑梗死伴 颅内动脉粥样硬化性狭窄的影响因素。 结论 apoB、apoB/apoA1 是颅内动脉粥样硬化性狭窄的独立危险因素，可能成为今后临床 上筛查与治疗高危人群的靶点。 |
| 关键词: 脑梗死 颅内动脉粥样硬化性狭窄 载脂蛋白 B 载脂蛋白 A1 影响因素 |
| DOI： |
| 分类号: |
| 基金项目:国家自然科学基金资助项目；温州市科技计划项目 |
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| Influencing factors of intracranial artery atherosclerotic stenosis in patients with cerebral infarction |
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ZHU Zhenguo,HUANG Yanjun,CHEN Yanyan,YIN Weiyong,YE Zusen,LIN Yuanshao,SHAO Bei
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the First Affiliated Hospital of Wenzhou Medical University
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| Abstract: |
| Objective To investigate the influencing factors of intracranial artery atherosclerotic stenosis in patients with cerebral infarction. Methods Total 464 hospitalized patients with cerebral infarction were enrolled. All patients were examined by brain MRA and cervical CEMRA, and according the results patients were divided into four groups, intracranial arterial stenosis (ICAS) group (n＝199), extracranial arterial stenosis (ECAS) group (n＝47), intracranial and extracranial arterial stenosis (IECAS) group(n＝113) and non-cranial arterial stenosis (NCAS) group(n＝105). The ICAS group was subdivide into two groups, moderate to severe intracranial arterial stenosis(grade≥50%, at least one vessel)(n＝135) and mild intracranial arterial stenosis (grade<50%) (n＝64). Serum biochemical markers, including TG, TC, LDL-C, HDL-C, apoB, apoA1, UA and Hcy were detected and compared, then influencing factors of intracranial artery atherosclerotic stenosis in patients with cerebral infarction were studied by univariate analysis and multiple logistic regression analysis. Results There were statistically significant differences among the four groups in the mean age, prevalence of hypertension and diabetes mellitus, level of TC, LDL-C, apoA1, apoB and apoB/apoA1 ratio(P＜0.05).The extracranial stenosis was mainly located in extracranial internal carotid artery and extracranial vertebra artery, and the intracranial vascular lesions were mainly located in middle cerebral artery and internal carotid artery. Level of apoB in patients with multiple intracranial artery stenosis was much higher than that in patients with single intracranial artery stenosis (P ＜0.05).Multivariate regression showed that apoB(OR=8.821), apoB/apoA1(OR=10.149) and smoking(OR=2.093) were influencing factors of intracanial artery atherosclerotic stenosis in patients with cerebral infarction. Conclusion The results suggest that apoB and apoB/apoA1 ratio are independent risk factors for intracranial arterial atherosclerotic stenosis, which would be the target for screening and treatment in high-risk population. |
| Key words: Cerebral infarction Intracranial artery atherosclerotic stenosis apoB apoA1 Influencing factors |
