颅内动脉狭窄致初发或复发缺血性卒中比较研究

Comparative study on clinical characteristics of primary or recurrent cerebral infarction caused by intracranial artery stenosis

目的分析和比较颅内动脉狭窄患者初发或复发缺血性卒中的临床特点。探讨颅内动脉狭窄程度与危险因素的关系。方法横断面研究,连续收集81例颅内动脉狭窄致缺血性卒中患者,复发缺血性卒中占41.98%,比较初发组和复发组的临床及影像学特点。结果初发组糖化血红蛋白（5.61±2.02）%,复发组（6.73±1.43）%,P〈0.05;初发组糖尿病比例23.40%,复发组50%,P〈0.05。颅内动脉狭窄程度与危险因素总数（高血压、糖尿病、高脂血症、卒中病史、心房纤颤、家族史和吸烟史）低度相关,r=0.245,P=0.028。Logistic回归示白细胞计数（大于7.03×10^9/L）是中重度颅内动脉狭窄的保护因素（OR=0.123,P=0.028,95%可信区间0.019~0.797）。结论颅内动脉狭窄致复发缺血性卒中组患者糖化血红蛋白和糖尿病比例更高。白细胞计数是中重度颅内动脉狭窄的保护因素。

Objective To investigate and compare the clinical characteristics of primary or recurrent cerebral infarc- tion in patients with intracranial artery stenosis. To analyze the correlation between stenosis degree and risk factors. Meth- ods Cross-sectional study,collected clinical and imaging features of 81 patients with intracranial artery stenosis and cere- bral infarction. Results Proportion of recurrent cerebral infarction in this small sample size population was 41.98%. Gly- cosylated hemoglobin in primary cerebral infarction group was （5.61 ± 2.02） %, the recurrent group was （6.73 ± 1.43 ） %, P 〈 0.05. Diabetes mellitus proportion in primary cerebral infarction group was 23.40% , the recurrent cerebral infarction group was 50% , P 〈 0.05. The severity of intracranial arterial stenosis and total number of risk factors （ hypertention, diabe- tes mellitus, hyperlipidemia, stroke history, atrial fibrillation, family history and smoking history ） were low correlated, P = 0.028, r = 0. 245. Logistic regression showed that mild increase in white blood cells （ greater than 7.03 × 10^9/L） was a pro- tective factor in moderate to severe intracranial artery stenosis （OR = 0. 123, P = 0. 028,95% confidence interval 0. 019 - 0. 797）. Conclusion Glycosylated hemoglobin and diabetes ratio in patients with recurrent ischemic stroke and intracrani- al artery stenosis group was higher than primary ischemic stroke. White blood cells count is a protective factor for moderate and severe intracranial artery stenosis.