颈内动脉颅内段钙化对轻型缺血性脑卒中患者预后的影响

Effect of intracranial internal carotid artery calcification on prognosis of patients with mild ischemic stroke

目的依据头颅计算机断层扫描(CT)和CT灌注成像(CTP)评估颈内动脉颅内段钙化(I-ICAC)程度,探讨其与轻型缺血性脑卒中(MIS)患者转归的相关性。方法回顾性分析MIS患者228例,获得根据CT和CTP结果评估的I-ICAC分值,并将患者分成I-ICAC轻症组152例和I-ICAC重症组76例。观察2组90 d缺血性脑卒中复发情况;观察2组90 d时美国国立卫生研究院卒中量表(NIHSS)评分、改良Rankin评分表(mRS)评分改善情况以及全因死亡率。结果相较于I-ICAC轻症组,I-ICAC重症组的缺血性脑卒中复发率升高,NIHSS评分改善率降低,差异有统计学意义(P<0.05);2组患者90 d mRS评分改善率及全因死亡率比较,差异无统计学意义(P>0.05)。结论I-ICAC重症患者缺血性脑卒中复发风险更高,应重视对MIS患者的I-ICAC评估。

Objective To evaluate the degree of intracranial internal carotid artery calcifications(I-ICAC)according to the computed tomography(CT)and CT perfusion imaging(CTP),and to explore the correlation between degree of I-ICAC and prognosis in patients with mild ischemic stroke(MIS).Methods A retrospective analysis was performed for 228 MIS patients,and they were divided into mild I-ICAC group(n=152)and severe I-ICAC group(n=76)according to I-ICAC scores evaluated on the basis of CT and CTP results.The 90-day recurrence of ischemic stroke of two groups was observed,and the improvement conditions of 90-day National Institutes of Health Stroke Scale(NIHSS)score,90-day modified Ranking Scale(mRS)score and all-cause mortality were observed as well.Results Compared with the mild I-ICAC group,the recurrence rate of ischemic stroke in the severe I-ICAC group was significantly higher,and the ratio of cases with improvement rate of NIHSS score was significantly lower(P<0.05).There were no significant differences in the ratio of cases with improvement rate of 90-day mRS score and all-cause mortality between the two groups(P>0.05).Conclusion Patients with severe I-ICAC have higher risk of ischemic stroke recurrence,so we should pay more attention to the I-ICAC evaluation of patients with MIS.