应用高分辨率磁共振对症状性大脑中动脉斑块稳定性危险因素的研究

The research on the risk factors of plague stability in the symptomatic middle cerebral artery using high resolution magnetic resonance imaging

目的应用高分辨率磁共振(High Resolution Magnetic Resonance Imaging,HRMRI)判断急性缺血性脑卒中患者症状大脑中动脉粥样硬化斑块稳定性,研究影响斑块稳定性的危险因素。方法连续收集2015年1月-2018年11月于江苏省苏北人民医院神经内科住院的急性缺血性脑卒中患者62例,责任动脉均为大脑中动脉,通过HRMRI评估症状大脑中动脉斑块稳定性,根据斑块稳定性,分为不稳定斑块组44例,稳定斑块组18例,比较两组之间的临床资料,分析影响急性缺血性脑卒中患者症状大脑中动脉粥样硬化斑块稳定性的危险因素。结果不稳定斑块组与稳定斑块组比较,两组在性别、年龄、糖尿病病史、吸烟史、饮酒史、白蛋白、总蛋白、高密度脂蛋白、尿酸等方面差异无统计学意义,不稳定斑块组高血压病史患者更多;甘油三脂、总胆固醇、低密度脂蛋白、空腹血糖的水平更高,Logistic回归分析提示甘油三脂(r=0.183,95%CI 0.037~0.905,P=0.037)是影响症状性大脑中动脉斑块稳定性的独立危险因素。结论甘油三脂水平可能与缺血性脑卒中症状性大脑中动脉粥样硬化斑块稳定性独立相关。

Objective To investigate the stability of atherosclerotic plaque in the symptomatic middle cerebral artery in patients with acute ischemic stroke using high resolution magnetic resonance imaging,and to study the risk factors of plaque stability.Methods From January 2015 to November 2018,62 consecutive patients with acute ischemic stroke at Subei People’s Hospital were enrolled retrospectively.The responsible arteries were middle cerebral arteries,and the symptoms of middle cerebral artery plaque stability were assessed by HRMRI.According to plaque stability,44 cases were divided into unstable plaque group and 18 cases were divided into stable plaque group.The clinical data between the two groups were compared.Logistic regression analysis was used to confirm the risk factors of plaque stability.Results There were no significant differences in sex,age,history of diabetes,smoking history,drinking history,albumin,total protein,high-density lipoprotein,and uric acid between the unstable plaque group and the stable plaque group.The hypertension history,triglyceride,total cholesterol,low density lipoprotein,fasting blood glucose were significantly different between the two groups.Multivariable logistic regression analysis showed triglyceride was an independent risk factor for plaque stability.Conclusion Triglyceride levels may be independently associated with the stability of atherosclerotic plaque in the symptomatic middle cerebral artery in patients with acute ischemic stroke.