无卒中患者脑小血管病总负荷与颅内外动脉硬化的相关性研究

Correlation between Total Burden of Cerebrovascular Disease and Extracranial and Extracranial Arteriosclerosis in Stroke-free Patients

【目的】探讨脑小血管病(cerebralsmallvesseldisease,cSVD)影像学标记物及cSVD总负荷与无卒中患者颅内外动脉硬化程度的相关性。【方法】收集200例无卒中患者的临床特征及颈动脉超声、脑核磁共振(magneticresonanceimaging,MRI)、电脑断层颅内血管摄影(computedtomographyangiography,CTA)检查等临床资料。对入组患者的cSVD影像学标记物进行总负荷评分。根据患者颅外和颅内动脉硬化评分评估颅内外动脉硬化程度;比较不同全脑cSVD总负荷评分患者的基线资料及颅内外动脉硬化评分变化;分析各类cSVD影像学标记物评分及cSVD总负荷评分与颅内外动脉硬化评分的相关性。【结果】不同全脑cSVD总负荷评分患者的年龄、高同型半胱氨酸、颅内动脉狭窄、颈动脉斑块、颅内动脉硬化评分、颅外动脉硬化评分、颅内外动脉硬化总分比较,差异均有统计学意义(P<0.01)。全脑cSVD总负荷评分与颅外、颅内、颅内外动脉硬化总分均呈正相关(rs分别为0.594、0.401、0.535,均P<0.01);一侧大脑半球cSVD总负荷评分与同侧颅外、颅内、颅内外动脉硬化评分的相关性明显大于与对侧颅外、颅内、颅内外动脉硬化的相关性(同侧rs分别为0.616、0.465、0.612,对侧rs分别为0.495、0.355、0.478,均P<0.01)。除半卵圆中心血管周围间隙(PVSs)评分外,其他cSVD影像学标记物评分与颅外、颅内、颅内外动脉硬化总分均呈正相关。【结论】颅内外动脉硬化越重,同侧及全脑cSVD负荷也越重;颅内外动脉硬化与除半卵圆中心PVSs外的各类cSVD的病变程度呈正相关。

【Objective】To investigate the correlation and clinical characteristics between imaging markers and total load of cSVD and the degree of extracranial and extracranial arteriosclerosis in patients without stroke.【Methods】The clinical features,carotid ultrasound,magnetic resonance imaging(MRI)and computed tomography angiography(CTA)of 200 stroke-free patients were collected.The total load score of cSVD imaging markers was performed.The degree of extracranial and intracranial arteriosclerosis was evaluated according to the scores of extracranial and intracranial arteriosclerosis;The baseline data and extracranial and extracranial arteriosclerosis scores of patients with different global cSVD total load scores were compared;The correlation between various cSVD imaging marker scores,cSVD total load score and extracranial and extracranial arteriosclerosis score was analyzed.【Results】There were significant differences in age,high homocysteine,intracranial artery stenosis,carotid plaque,intracranial arteriosclerosis score,extracranial arteriosclerosis score and total extracranial and extracranial arteriosclerosis score among patients with different total cerebral cSVD load score(P<0.01).The whole brain cSVD total load score was positively correlated with the total scores of extracranial,intracranial and extracranial arteriosclerosis(rs=0.594,0.401 and 0.535,respectively,P<0.01);The correlation between cSVD total load score in one hemisphere and ipsilateral extracranial,intracranial and extracranial arteriosclerosis scores was significantly greater than that with contralateral extracranial,intracranial and extracranial arteriosclerosis(ipsilateral rs=0.616,0.465 and 0.612,and contralateral rs=0.495,0.355 and 0.478,respectively,P<0.01).Except for the PVSs score in the semioval center,the scores of other cSVD imaging markers were positively correlated with the total scores of extracranial,intracranial and extracranial arteriosclerosis.【Conclusion】The more severe the intracranial and extracranial arteriosclerosis,the heavier the ipsilateral and whole brain cSVD load;Extracranial and extracranial arteriosclerosis was positively correlated with the degree of lesions of various cSVD except PVSs in the center of semioval.