摘要
目的探讨症状性慢性颈内动脉闭塞(CICAO)患者发生内分水岭性梗死(IBZ)的相关因素。方法选取2011年1月至2019年5月期间于苏州市第九人民医院和苏州大学附属第二医院的症状性CICAO患者,将所有患者分为IBZ组和非IBZ组,收集两组患者人口学资料、实验室检查及影像学资料结果,采用多因素logistic回归模型分析症状性CICAO患者发生IBZ的相关因素。结果共185例患者纳入研究,年龄(65±11)岁,男147例,女38例。IBZ组64例,非IBZ组121例。IBZ组眼动脉反流患者的比例为64.1%(41/64),高于非IBZ组47.8%(55/121)(P=0.037);非IBZ组侧支代偿(ASTIN/SIR 3~4级)的比例为66.1%(80/121),高于IBZ组29.7%(19/64)(P<0.001)。脑梗死病史(OR=2.233,95%CI:1.023~4.874)、低密度脂蛋白胆固醇(LDL)(OR=1.516,95%CI:1.006~2.285)、眼动脉反流(OR=5.060,95%CI:1.160~22.081)是症状性CICAO患者发生IBZ的危险因素(均P<0.05);凝血酶原国际标准化比值(INR)(OR=0.010,95%CI:0.000~0.970)及侧支代偿(ASTIN/SIR 3~4级)(OR=0.172,95%CI:0.079~0.373)是症状性CICAO患者发生IBZ脑的保护因素(均P<0.05)。结论有眼动脉反流、LDL、脑梗死病史是症状性CICAO患者发生IBZ的危险因素;INR及侧支代偿(ASTIN/SIR 3~4级)是症状性CICAO患者发生IBZ的保护因素。
Objective To explore the related factors of internal border-zone(IBZ)infarcts in patients with symptomatic chronic internal carotid artery occlusion(CICAO).Methods From January 2011 to May 2019,the symptomatic CICAO patients in the Second Affiliated Hospital of Soochow University and the Ninth People′s Hospital of Suzhou were retrospectively analyzed.The patients were divided into IBZ group and non-IBZ group.The demographic data,laboratory examination and imaging data of the two groups were collected.Binary logistic regression analysis was used to identify the related factors of IBZ infarcts in patients with symptomatic CICAO.Results A total of 185 patients(147 males and 38 females)were finally enrolled,with a mean age of(65±11)years old.There were 64 and 121 cases in IBZ group and non-IBZ group,respectively.The ratio of patients with ophthalmic artery(OA)reflux in IBZ group was 64.1%(41/64),which was significantly higher than that in non IBZ group[47.8%(55/121),P=0.037],while the ratio of patients with collateral compensation(ASTIN/SIR 3-4)in non-IBZ group was 66.1%(80/121),which was significantly higher than that in IBZ group[29.7%(19/64),P<0.001].Multivariate logistic regression analysis showed that history of cerebral infarction(OR=2.233,95%CI:1.023-4.874),low density lipoprotein(LDL)(OR=1.516,95%CI:1.006-2.285)and OA reflux(OR=5.060,95%CI:1.160-22.081)were independent risk factors for IBZ infarcts in patients with symptomatic CICAO(all P<0.05);while prothrombin international normalized ratio(INR)(OR=0.010,95%CI:0.000-0.970)and collateral compensation(ASTIN/SIR 3-4)(OR=0.172,95%CI:0.079-0.373)were protective factors(all P<0.05).Conclusion OA reflux,LDL,and history of cerebral infarction are independent risk factors for IBZ infarcts in patients with symptomatic CICAO,while INR and collateral compensation scores(ASTIN/SIR 3-4)are the protective factors.
作者
翟国杰
徐元
杨秀艳
盛习华
肖国栋
曹勇军
Zhai Guojie;Xu Yuan;Yang Xiuyan;Sheng Xihua;Xiao Guodong;Cao Yongjun(Department of Neurology,the Ninth People's Hospital of Suzhou,Suzhou 215200,China;Department of Neurology,the Second Affiliated Hospital of Soochow University,Suzhou 215004,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2022年第37期2950-2955,共6页
National Medical Journal of China
基金
国家自然科学基金面上项目(82171296)
苏州市2018年科技发展计划项目(sys2018061)。
关键词
脑梗死
颈内动脉闭塞
分水岭
危险因素
横断面研究
Cerebral infarction
Internal carotid artery occlusion
Watershed
Risk factors
Cross sectional study
