颅内动脉狭窄与急性缺血性卒中严重程度的相关性研究

Study of correlation between intracranial arterial stenosis and the severity of acute ischemic stroke

目的探讨颅内动脉狭窄程度及分布情况与急性缺血性卒中患者发病早期神经功能损伤严重程度的关系。方法以139例急性缺血性卒中患者为研究对象,根据患者入院时NIHSS评分将其分为轻中型卒中组(NIHSS评分<8)和重型卒中组(NIHSS评分>8),同时收集患者一般资料,所有患者均通过磁共振血管成像技术(MRA)观察其颅内血管病变情况,多根血管狭窄患者记录狭窄程度最严重的血管病变情况。结果139例患者中,重型卒中组22例,年龄大于轻中型卒中组[(75.77±11.31)岁vs(68.30±12.58)岁,P<0.05]。重型卒中组狭窄比例高于轻中型卒中组(95.45%vs 65.81%,P<0.01),两组人群中前循环狭窄比例高(72.73%vs 42.74%,P<0.05).卒中严重程度与狭窄的严重程度呈正相关性(r=0.050,P<0.001)。多因素Logistic回归调整性别、年龄、高血压病、糖尿病、既往卒中史后,分别得出狭窄(OR=9.603,95%CI:1.196〜77.114);前循环狭窄(OR=3.589,95%CI:1.205〜10.696)与卒中严重程度相关。结论颅内动脉狭窄患者较非狭窄患者卒中病情严重,前循环狭窄与其具有相关性。

Objective To explore the correlation between the degree and distribution of intracranial arterial stenosis and the severity of neurological damage in patients with acute ischemic stroke in early stage.Methods A total of 139 patients with acute ischemic stroke were studied.The patients were divided into mild stroke group(NHISS score<8)and severe stroke group(NHISS score≥8)according to the NIHSS score at admission.All patients were observed for intracranial vascular lesions by magnetic resonance angiography(MRA).Patients with multiple vessel stenosis recorded the most severe vascular lesions.Results Among the 139 patients,22 in the severe stroke group were older(75.77±11.31 years vs 68.30±12.58 years,P<0.05).The proportion of stenosis in the severe stroke group was higher than that in the light group(95.45%vs 65.81%,P<0.01)The proportion of anterior circulation stenosis was high in the two groups(72.73%vs 42.74%,P<0.05).The severity of stroke was correlated with the severity of stenosis(r=0.050,P<0.001).Multivariate Logistic regression adjusted for age,gender,hypertension,diabetes,and previous stroke history,re-sulting in stenosis(OR=9.6O3,95%CI:1.196〜77.114);anterior circulation stenosis(OR=3.589,95%CI:1.205〜10.696)correlated with the severity of stroke.Conclusion Patients with intracranial arterial stenosis have a more severe stroke than non-stenotic patients,and anterior circulation stenosis is related to it.