中国缺血性脑卒中患者颅内外动脉病变分布及其与主要危险因素相关性的多中心研究
Correlation between the distribution of intracranial and extracranial aterial lesions and risk factors in Chinese patients with ischemic stroke:a multicenter registry study
查看参考文献22篇
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文摘
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目的探讨中国缺血性脑卒中患者颅内外动脉病变的分布特征及危险因素的差异.方法连续性纳入2015年6月至2016年5月全国20家国家卫计委脑卒中筛查与防治基地医院临床明确诊断的缺血性脑卒中患者共2310例,所有患者均行颈动脉彩色多普勒超声及经颅彩色多普勒或经颅多普勒超声检查发现存在脑动脉狭窄或闭塞.根据病变部位分为单纯颅外动脉病变组和单纯颅内动脉病变组,比较两组之间脑血管病危险因素暴露情况的差异性.结果2310例缺血性脑卒中患者中单纯颅内动脉病变1516例(65.6%),单纯颅外动脉病变794例(34.4%).颅内动脉病变组前循环动脉病变发生率明显高于颅外动脉病变组(68.1% 对48.7%,P<0.001).颅外动脉病变组后循环动脉病变及前、后循环动脉合并存在病变发生率均显著高于颅内动脉病变组(36.4% 对22.1%,14.9% 对9.8%;均P<0.001).对脑卒中危险因素进行单因素分析显示,颅内动脉病变组高血压、糖尿病、肥胖、脑卒中家族史所占比例高,且其收缩压、舒张压、体质指数(body mass index,BMI)、空腹血糖、糖化血红蛋白、甘油三酯、总胆固醇、低密度脂蛋白胆固醇水平显著高于颅外动脉病变组(均P<0.05).颅外动脉病变组高龄、男性及吸烟者比例显著高于颅内动脉病变组(均P<0.05).多因素Logistic回归分析显示,高龄(≥65岁)、男性、吸烟史为单纯颅外动脉病变的独立危险因素(OR=2.012,1.637,1.325;均P<0.05).高血压、糖尿病、较少体育运动、高BMI水平为单纯颅内动脉病变的独立危险因素(OR=1.301,1.252,1.248,1.030;均P<0.05).结论中国缺血性脑卒中患者颅内、外动脉病变的分布特征及其危险因素存在明显差异. |
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其他语种文摘
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Objective To investigate the distribution characteristics and risk factors of intracranial and extracranial aterial lesions in Chinese patients with ischemic stroke.Methods In this multi-center study,2 310 continuously inpatients with ischemic stroke diagnosed in 20 stroke screening and prevention project base hospitals from June 2015 to May 2016 were enrolled.Carotid ultrasonography and transcranial color-coded sonography or transcranial Doppler were performed in all patients to confirm the presence of cerebral artery stenosis or occlusion.According to the distribution of lesions,the subjects were divided into 2 groups:the simple intracranial artery stenosis group and the simple extracranial artery stenosis group.The difference of risk factors between the two groups was compared.Results Of the 2 310 patients with ischemic stroke,1 516 (65.6%) had simple intracranial artery stenosis and 794 (34.4%) had simple extracranial artery stenosis.The incidence of anterior circulation artery stenosis was higher in the group of intracranial artery stenosis than that in the extracranial artery stenosis group (68.1% vs 48.7%,P<0.001).Posterior circulation artery stenosis and combined anterior with posterior circulation artery stenosis were more common in patients with extracranial artery stenosis group than those in intracranial artery stenosis group (36.4% vs 22.1%,14.9% vs 9.8%;all P<0.001).Univariate analysis of risk factors for stroke showed that patients with intracranial arterial stenosis had a higher prevelence of hypertension,diabetes,obesity,and family history of stroke,and their systolic blood pressure,diastolic blood pressure,body mass index (BMI),fasting blood-glucose,glycosylated hemoglobin,triacylglycerol,total cholesterol,and low-density lipoprotein cholesterol were significantly higher than those in the extracranial arterial stenosis group (all P<0.05).The proportion of elderly (≥65 years old),male and smokers in the extracranial arterial stenosis group was significantly higher than that in the intracranial arterial stenosis group (all P<0.05).Multivariate logistic regression analysis showed that elderly (≥65 years old),male,and smoking history were independent risk factors for extracranial arterial stenosis (OR=2.012,1.637,1.325,respectively;all P<0.05).While hypertension,diabetes,less physical activity,and high BMI levels were independent risk factors for simple intracranial arterial disease (OR=1.301,1.252,1.248,1.030,respectively;all P<0.05).Conclusions There are significant differences in the distribution characteristics and risk factors of intracranial and extracranial aterial lesions in patients with ischemic stroke in China. |
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来源
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中华超声影像学杂志
,2019,28(5):369-374 【核心库】
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DOI
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10.3760/cma.j.issn.1004-4477.2019.05.001
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关键词
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超声检查
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缺血性脑卒中
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动脉狭窄
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分布
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危险因素
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地址
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1.
首都医科大学宣武医院血管超声科, 北京, 100053
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吉林大学第一医院神经内科, 长春, 130021
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苏州大学附属第一医院超声科, 215006
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兰州大学第二医院超声科, 730030
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天津市环湖医院超声科, 300350
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大连医科大学附属大连市中心医院超声科, 116003
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山西医科大学第一医院超声科, 太原, 030001
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洛阳市中心医院神经内科, 471009
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山东省聊城市人民医院脑科医院超声科, 252000
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哈尔滨医科大学附属第一医院超声科, 150001
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安徽省立医院超声科, 合肥, 230001
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中国医科大学附属第一医院超声科, 沈阳, 110001
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包头市中心医院神经内科, 014040
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福建省立医院超声科, 福州, 350001
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绵阳市中心医院超声科, 621000
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新疆医科大学第一附属医院超声科, 乌鲁木齐, 830054
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广东省中医院超声科, 广州, 510120
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昆明医科大学第二附属医院神经内科, 650101
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珠海市人民医院超声科, 519000
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湖南省脑科医院超声科, 长沙, 430007
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语种
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中文 |
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文献类型
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研究性论文 |
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ISSN
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1004-4477 |
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学科
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医药、卫生 |
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基金
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国家卫生计生委脑卒中筛查与防治工程委员会资助
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文献收藏号
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CSCD:6509863
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