豆纹动脉和脑小血管病相关特征与豆纹动脉区域梗死亚型的关系研究

Study on the relationship between the characteristics of lenticulostriate artery and cerebral small vascular disease and the subtypes of infarct in lenticulostriate artery

目的探讨豆纹动脉(LSA)和脑小血管病相关特征与LSA区域梗死亚型的关系。方法回顾性分析2020年9月至2022年6月成都市第二人民医院神经内科收治的44例LSA供血区首次单发近期梗死患者资料,根据发病机制分为分支动脉粥样硬化疾病(BAD)组和近期腔隙性梗死(LI)组。对LSA区域梗死亚型(BAD组25例,LI组19例)和正常组(20例)的LSA特征、脑小血管病相关指标和临床资料等进行对比分析,并采用多因素logistic回归分析确定LSA区域梗死亚型的影响因素。结果BAD组入院美国国立卫生研究院卒中量表(NHISS)评分高于LI组,差异有统计学意义(P<0.05)。3组高血压患病率、低密度脂蛋白(LDL)水平、LSA总长度和腔隙灶发生率比较,差异有统计学意义(P<0.05)。BAD组和LI组高血压患病率、LDL水平高于正常组(P<0.05);BAD组和LI组LSA总长度短于正常组,且BAD组短于LI组(P<0.05);LI组腔隙灶发生率高于BAD组和正常组(P<0.05)。多因素logistic回归分析结果显示,以正常组作为对照,LDL和LSA总长度是LSA区域梗死(BAD或LI发生)的影响因素(P<0.05);以BAD组作为对照,LSA总长度和腔隙灶是LI发生的影响因素(P<0.05)。结论LSA总长度和腔隙灶可作为区别LSA区域梗死亚型的影像学指标。

Objective To explore the relationship between the characteristics of lenticulostriate artery(LSA)and cerebral small vascular disease and the subtypes of infarct in LSA.Methods The data of 44 patients with the first single recent infarction in LSA blood supply area admitted to the Department of Neurology of Chengdu Second People’s Hospital from September 2029 to June 2022 were collected.According to the pathogenesis,the patients were divided into the branch atheromatous disease(BAD)group and the lacunar infarct(LI)group.The characteristics of LSA,cerebral small vessel disease(CSVD)related indicators and clinical data of the LSA area infarction subtype group(25 cases in the BAD group and 19 cases in the LI group)and the normal group(20 cases)were compared and analyzed,and the influencing factors of LSA area infarction subtypes were determined by multi-classification logistic regression analysis.Results The score of the National Institutes of Health Stroke Scale(NHISS)in the BAD group was higher than that in the LI group,and the difference was statistically significant(P<0.05).The prevalence of hypertension,the level of low density lipoprotein(LDL),the total length of LSA,and the incidence of lacunar foci were significantly different among the three groups(P<0.05).The prevalence of hypertension and LDL level in the BAD group and the LI group were higher than those in the normal group(P<0.05).The total length of LSA in the BAD and LI groups was shorter than that in the normal group,and the BAD group was shorter than that in the LI group(P<0.05).The incidence of lacunar foci in the LI group was higher than that in the BAD group and the normal group(P<0.05).Multiple logistic regression analysis showed that the total length of LSA and LDL were influencing factors for infarction in the LSA area(BAD or LI)compared to the normal group(P<0.05).Compared with the BAD group,the total length of LSA and the lacunar foci were the risk factors for LI(P<0.05).Conclusion Imaging indicators such as total length LSA and lacunar foci can be used as imaging indexes to distinguish the LSA regional infarction subtype.