前循环与后循环缺血性卒中的危险因素比较——回顾性病例系列研究

Comparison of the risk factors for anterior circulation and posterior circulation ischemic stroke a retrospective case series study

目的探讨前循环与后循环缺血性卒中血管危险因素的差异。方法制定统一的青岛市缺血性卒中诊治现状调查表，回顾性收集青岛市、县两级具备影像学检查设施（CT或MRJ）的11家医院神经内科2008年6月至2009年2月期间连续就诊的943例急性缺血性卒中患者资料，分析前循环和后循环缺血性卒中患者的危险因素。结果单变量分析显示，前循环和后循环缺血性卒中患者的年龄、性别、冠心病史、高脂血症、心房颤动和基线国立卫生研究院卒中量表（National Institutes of Health Stroke Scale，NIHSS）评分存在显著差异（P均〈0．05）。多变量logistic回归分析显示，年龄[优势比（oddsratio，OR）1．025，95％可信区间（confidence interval，CI）1．009～1．042]、基线NIHSS评分（OR1．052，95％CI1．019～1．086）倾向于前循环缺血性卒中，冠心病（OR0．512，95％C10．341～0．768）、高脂血症（OR0．585，95％C10．386～0．884）倾向于后循环缺血性卒中，且高脂血症为后循环缺血性卒中的独立危险因素。结论血管性危险因素对前循环和后循环缺血性卒中所施加的效应不同。

Objective To investigate the differences of the vascular risk factors for anterior circulation and posterior circulation ischernic stroke. Methods The unified diagnosis and treatment questionnaires of ischernic stroke in Qingdao city were developed. The data of 943 consecutive patients with acute ischemic stroke treated in the Departments of Neurology in 11 hospitals with hinging facilities such as computerized tomography （CT） or magnetic resonance imaging （MRI） in Qingiao city and its surrounding counties from June 2008 to February 2009 were retrospectively collected. The risk factors for anterior circulation and posterior circulation ischemic stroke were analyzed. Results Univariate analysis showed that there were significant differences in the age, sex, history of coronary heart disease, hyperlipidemia, atrial fibrillation and baseline National Institutes of Health Stroke Scale （NIHSS） score between anterior circulation and posterior circulation ischemic stroke （all P 〈0. 05）. Multivariate logistic regression analysis showed that the age （odds ratio [ OR] 1.025, 95% confidence interval [ CI] 1. 009-1.042） and the baseline NIHSS score （OR 1.052, 95% CI 1.019-1.086） tended to the anterior circulation ischemic stroke, whereas coronary heart disease （OR 0. 512, 95% CI 0. 341-0. 768） and hyperlipidemia （OR 0. 585, 95% CI 0. 386- 0. 884） tended to posterior circulation ischemic stroke, and hyperlipidemia was an independent risk factors for posterior circulation ischemic stroke. Conclusions Vascular risk factors exerted different effects on anterior circulation and posterior circulation ischemic stroke.