颅内动脉中重度狭窄的危险因素研究

The Preliminary Study of Risk Factors in Patients with Symptomatic Intracranial Stenosis

目的探讨颅内动脉狭窄的危险因素。方法2006年4月～12月连续收集急性缺血性卒中患者136例,所有病例均行脑血管数字减影血管造影(DSA)或经颅多普勒超声(TCD)联合磁共振血管成像(MRA)确定是否存在颅内血管狭窄。63例(46.3%)颅内动脉存在中度以上狭窄患者作为病例组,73例(53.7%)无明显颅内动脉狭窄患者作为对照组,对两组患者的危险因素进行统计学分析。研究变量包括人口学因素、既往病史及个人史。结果单变量分析发现两组患者间高血压、脂代谢紊乱、缺血性心脏病、吸烟史水平间差别有显著性意义(P<0.05);多元logistic回归分析发现,高血压病(OR=2.631,95%CI1.124～6.160,P=0.026)、脂代谢紊乱(OR=2.255,95%CI1.060～4.797,P=0.035)是颅内动脉狭窄的独立危险因素。结论高血压、脂代谢紊乱可能是导致颅内动脉狭窄形成的独立危险因素,应进行大样本的队列研究加以证实。

Objective To investigate the risk factors of symptomatic intracranial stenosis. Methods Total 136 consecutive patients with acute ischemic stroke were enrolled during April to December in 2006 at Tiantan hospital. All stenosis vessels were found by digital subtraction angiography(DSA) or transcranial Doppler(TCD) and magnetic resonance angiography(MRA) examination. Of the 136 patients,63(46%) were found to have the evidence of intracranial median stenosis(defined as case group),73(54%) patients had no obvious stenosis(defined as control group). Risk factors of cerebrovascular disease were comparatively investigated between the 2 groups. The variables included the demographic characteristics,past medical history,such as hypertension,diabetes,lipid disorders,homocysteine,ischemic cardiac disease,atrial fibrillation,smoking,alcohol drinking,prolonged sitting lifestyle and body mass index(BMI). Results Univariate analysis showed that there were significant differences between 2 groups in hypertension,lipid disorders,ischemic cardiac disease and smoking. Multivariable logistic stepwise regression analysis found the hypertension(OR=2.631,95%CI 1.124-6.160,P=0.026) and lipid disorders(OR=2.255,95%CI 1.060-4.797,P=0.035) were independent risk factors of symptomatic intracranial stenosis with acute ischemic stroke. Conclusion The study suggests that hypertension,lipid disorders may be independent risk factors of sympotomatic intracranial stenosis,and we need large cohort studies to confirm it.