影响急性缺血性脑卒中患者大脑侧支血管形成的相关因素分析

Analysis of Factors Related to Cerebral Collateral Vessel Formation in Patients with Acute Ischemic Stroke

目的分析影响急性缺血性脑卒中(AIS)患者大脑侧支血管形成的相关因素。方法回顾性分析本院83例AIS患者的临床资料,均行头颈部螺旋CT血管造影检查,根据患者检查结果,有大脑侧支血管形成者为A组,无大脑侧支血管形成者为B组。比较两组患者临床资料,并通过单因素分析及多因素Logistic回归分析影响AIS患者大脑侧支血管形成的相关因素。结果83例AIS患者中,有大脑侧支血管形成46例(55.42%),无大脑侧支血管形成37例(44.58%)。经单因素分析结果发现,年龄、短暂性脑缺血发作史、糖尿病伴高血压史、脑血管狭窄程度、高半胱氨酸(Hcy)、低密度脂蛋白-胆固醇(LDL-C)及后循环病变例数在两组患者间的比较,差异有统计学意义(P<0.05)。经多因素Logistic回归分析显示,高龄、Hcy升高、糖尿病伴高血压史及后循环病变均是AIS患者大脑侧支血管形成不良的独立危险因素(OR=3.56~10.70,P<0.05),LDL-C和脑血管狭窄程度均是AIS患者大脑侧支血管形成的促进因素(OR=0.02~0.46,P<0.05)。结论高龄、Hcy升高、糖尿病伴高血压史及后循环病变为AIS患者大脑侧支血管形成不良的危险因素,而LDL-C和脑血管狭窄程度为大脑侧支血管形成的促进因素。

Objective To analyze the related factors affecting the formation of cerebral collateral vessels in patients with acute ischemic stroke(AIS).Methods The clinical data of 83 patients with AIS in our hospital were retrospectively analyzed.All patients underwent spiral CT angiography of head and neck.According to the results of the patient’s examination,the patients with cerebral collateral angiogenesis were group A,and those without cerebral collateral angiogenesis were group B.The clinical data of the two groups were compared,and the related factors affecting the formation of cerebral collateral vessels in AIS patients were analyzed by single factor analysis and multiple logistic regression analysis.Results Among 83 AIS patients,there were 46 cases(55.42%)of collateral vessels and 37 cases(44.58%)of non-collateral vessels.Univariate analysis showed that there were statistical significance in age,transient ischemic attack,diabetes mellitus with hypertension,degree of cerebrovascular stenosis,homocysteine(Hcy),low-density lipoprotein cholesterol(LDL-C)and posterior circulation lesions between two groups(P<0.05).The results of multivariate logistic regression analysis showed that eldery,increased Hcy,history of diabetes mellitus with hypertension and posterior circulation lesions were independent risk factors for poor collateral vessels formation in patients with AIS(OR=3.56~10.70,P<0.05),while LDL-C and degree of cerebrovascular stenosis were promoting factors for collateral vessels formation in patients with AIS(OR=0.02~0.46,P<0.05).Conclusions Elderly,increased Hcy,history of diabetes mellitus combined with hypertension and posterior circulation lesions are risk factors for poor collateral vessels formation in patients with AIS,while LDL-C and degree of cerebrovascular stenosis are promoting factors for collateral vessels formation.