责任动脉狭窄程度与轻型卒中病情进展的关系
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(1.苏州大学附属第一医院神经内科, 江苏省苏州市 215006;2.无锡市人民医院神经内科, 江苏省无锡市 214043)

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何萍,博士研究生,副主任医师,主要从事脑血管病研究,E-mail为heping7807@hotmail.com。

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The Relationship Between Stenosis Degree of Criminal Artery and Progression in Acute Ischemic Minor Stroke
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1.Department of Neurology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China;2.Department of Neurology, Wuxi People’s Hospital, Wuxi, Jiangsu 214043, China)

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    摘要:

    目的 研究急性缺血性轻型卒中患者责任动脉狭窄程度与卒中病情进展的关系。方法 回顾性收集2013年6月至2014年9月苏州大学附属第一医院住院的104例急性缺血性轻型卒中患者的病历资料,按病情是否加重分为卒中进展组46例和卒中无进展组58例。患者急性期即行ABCD2评分,并通过DSA完成责任动脉狭窄程度检测。对ABCD2评分和责任动脉狭窄程度等相关临床数据行Logistic回归分析、Spearman相关分析及ROC曲线分析。结果 单因素Logistic回归分析显示卒中进展组责任动脉狭窄程度、ABCD2评分、多支病变程度、年龄和低密度脂蛋白等均高于卒中无进展组(P<0.05);Spearman相关分析显示责任动脉狭窄程度和ABCD2评分与轻型卒中进展具有相关性(rABCD2=0. 6890,P=0.000;r责任动脉狭窄程度=0. 4296,P=0.000);多因素Logistic回归分析显示责任动脉狭窄程度(OR=5.258,95%CI为1.124~24.608,P=0.035)、ABCD2评分(OR=8.010,95%CI为3.093~20.748,P=0.000)是轻型卒中病情进展的独立危险因素;ROC曲线分析表明两者曲线下面积(AUC)分别为:AUC责任动脉狭窄程度=0.7324,95%CI为0.64324~ 0.82153;AUCABCD2=0.8859,95%CI为0.83128~0.94046。结论 责任血管狭窄程度和ABCD2评分一样,是轻型卒中病情进展的独立危险因素,需要密切观察,及早进行临床干预。

    Abstract:

    Aim To investigate the relationship between stenosis degree of criminal artery and progression in acute ischemic minor stroke. Methods A total of 104 patients with acute ischemic minor stroke, admitted between June 2013 and September 2014,were enrolled. They were divided into progression group (n=46) and no progression group (n=58). The ABCD2 scores were recorded and the stenosis degree of criminal artery was evaluated by DSA during the early stage. The clinical data including ABCD2 score and the stenosis degree of criminal artery were analyzed by Logistic regression, Spearman correlation and ROC curve. Results The ABCD2 score, the stenosis degree of criminal artery, degree of artery involvement, age and LDL in progression group were significantly higher than those in no progression group by univariate binary Logistic regression. The stenosis degree of criminal artery (r=0.4296, P=0.000) and the ABCD2 score (r=0.6890, P=0.000) were significantly correlated with progression of minor stroke. The stenosis degree of criminal artery (OR=5.8,5% CI was 1.124~ 24.608, P=0.035) and the ABCD2 score (OR=8.0,5%CI was 3.093~20.748, P=0.000) were the independent risk factors of the progression of minor stroke by multivariate binary Logistic regression. The area under the curve (AUC) of stenosis degree of criminal artery was 0.4,5%CI was 0.64324~0.82153, and AUC of ABCD2 score was 0.9,5%CI was 0.83128~0.94046. Conclusion Stenosis degree of criminal artery is the independent risk factor of the progression of minor stroke as the same as ABCD2 score. More attentions are needed in treatment of minor stroke.

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何萍,张剑平,倪健强,方琪,董万利.责任动脉狭窄程度与轻型卒中病情进展的关系[J].中国动脉硬化杂志,2016,24(8):817~820.

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  • 收稿日期:2015-08-13
  • 最后修改日期:2015-12-05
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  • 在线发布日期: 2016-07-25