Aim YiQiFuMai Powder Injection is a well-known traditional Chinese medicine formula that has been used extensively in clinical treatment of cardio-cerebral ischemic diseases in China. However, the mechanisms under-lyi...Aim YiQiFuMai Powder Injection is a well-known traditional Chinese medicine formula that has been used extensively in clinical treatment of cardio-cerebral ischemic diseases in China. However, the mechanisms under-lying its clinical efficacy remain unknown. In this study, a network pharmacology approach was employed to identify the YiQiFuMai Powder Injection＇s potential pathways and targets against cardio-cerebral ischemia. The target-path- way interaction network clustered the signaling pathways based on high degree nodes of the drug-target network. The potential protein targets presented in the highly scored clustered pathways were the key network hubs and concentrated on one or limited functional signaling pathways amenable to experimental verification. Twelve main functional annota- tion clusters and main signaling pathways for YiQiFuMai Powder Injection were established by Biocarta analysis, in- eluding the NF-KB signaling pathway, the MAPKinase signaling pathway and the mTOR-signaling pathway and so on. YiQiFuMai Powder Injection is hypothesized to target multiple proteins with a high degree and betweenness of net- work. In addition, the most related pathways were also confirmed in tumor necrosis factor-alpha （TNF-oL） induced human vascular endothelial cell line EA. hy926 by Western blot. This study elucidates the systematic network and pathway analysis of multi-targets in YiQiFuMai Powder Injection. The results provide the possible mechanisms for its mode of action against cardio-cerebral ischemic diseases and may also reveal new clues for its potential application in the inflammatory diseases or tumors.展开更多
OBJECTIVE Numerous references made clear that triphala is revered as a multiuse therapeutic and perhaps even panacea historically.Nevertheless,the protective mechanism of triphala on cardio-cerebral vascular diseases(...OBJECTIVE Numerous references made clear that triphala is revered as a multiuse therapeutic and perhaps even panacea historically.Nevertheless,the protective mechanism of triphala on cardio-cerebral vascular diseases(CCVDs)remains not comprehensive understanding.Hence,a network pharmacology-based method was suggested in this study to address this problem.METHODS This study was based on network pharmacology and bioinformatics analysis.Information on compounds in herbal medicines of triphala formula was acquired from public databases.Oral bioavailability as well as drug-likeness were screened by using absorption,distribution,metabolism,and excretion(ADME)criteria.Then,components of triphala,candidate targets of each component and known therapeutic targets of CCVDs were collected.Compound-target gene and compounds-CCVDs target networks were created through network pharmacology data sources.In addition,key targets and pathway enrichment were analyzed by STRING database and DAVID database.Moreover,we verified three of the key targets(PTGS2,MMP9 and IL-6)predicted by using Western blotting analysis.RESULTS Network analysis determined 132 compounds in three herbal medicines that were subjected to ADME screening,and 23 compounds as well as 65 genes formed the principal pathways linked to CCVDs.And 10 compounds,which actually linked to more than three genes,are determined as crucial chemicals.Core genes in this network were IL-6,TNF,VEGFA,PTGS2,CXCL8,TP53,CCL2,IL-10,MMP9 and SERPINE1.And pathways in cancer,TNF signaling path⁃way,neuroactive ligand-receptor interaction,etc.related to CCVDs were identified.In vitro experiments,the results indi⁃cated that compared with the control group(no treatment),PTGS2,MMP9 and IL-6 were up-regulated by treatment of 10μg·L^-1 TNF-α,while pretreatment with 20-80 mg·L^-1 triphala could significantly inhibit the expression of PTGS2,MMP9 and IL-6.With increasing Triphala concentration,the expression of PTGS2,MMP9 and IL-6 decreased.CON⁃CLUSION Complex components and pharmacological mechanism of triphala,and obtained some potential therapeutic targets of CCVDs,which could provide theoretical basis for the research and development of new drugs for treating CCVDs.展开更多
Respiratory disease and cardio-cerebral vascular disease frequently occur in Anyang City. In this paper, by comparing incidence num- bers of respiratory disease and cardio-cerebral vascular disease in Anyang People＇s...Respiratory disease and cardio-cerebral vascular disease frequently occur in Anyang City. In this paper, by comparing incidence num- bers of respiratory disease and cardio-cerebral vascular disease in Anyang People＇s Hospital during 2010 -2012 with seasonal change of local tem- perature,it is found that they have obvious relationship, which has very important significance for preventing respiratory disease and cardio-cerebral vascular disease in the future.展开更多
With the progress in global demography of aging, dementia has become a great world health-care issue that require urgent attention and settlement. Demen-tia can arise from a variety of factors, such as neuronal degene...With the progress in global demography of aging, dementia has become a great world health-care issue that require urgent attention and settlement. Demen-tia can arise from a variety of factors, such as neuronal degeneration for Alzheimer’s disease （AD）, vascular risk factors and multiple infarcts for vascular dementia （VaD）, and both degeneration and vascular factors for mixed de-mentia （MD）. Pathophysiology of AD includes the amy-loid and tau protein hypothesis, and infammation-related mechanisms are also widespread mentioned. Subcortical ischemic vascular dementia （SIVD）, a subtype of VaD, is commonly caused by complete or incomplete lacunar infarction of VaD pathology. MD involves both degenera-tion and vascular factors, and the interaction between the two results in the complication of the pathological mech-anism and clinical phenotype. The clinical manifestationsof AD are often divided into four stages according to the progress of the disease, while the phenotypes of SIVD usually has two categories. As for MD, the phenotypes are complex and diverse. Several clinical studies showedthat its symptoms and signs are more similar to SIVD than AD. This article aims to analyze and compare the differ-ent aspects of the three kinds of dementia.展开更多
BACKGROUND Ischemic gastritis is a clinically rare disease with high mortality that infrequently reported in the medical literature and under-recognized clinically and histopatho-logically.Early diagnosis and treatmen...BACKGROUND Ischemic gastritis is a clinically rare disease with high mortality that infrequently reported in the medical literature and under-recognized clinically and histopatho-logically.Early diagnosis and treatment can only be achieved through upper gastrointestinal endoscopy after symptoms appear.CASE SUMMARY A 68-year-old woman with a history of intracranial aneurysm developed dizziness,chest tightness and unconsciousness for 2 d.Computed tomography angiography showed diffuse coronary atherosclerosis,moderate to severe stenosis in the proximal end of the left anterior descending branch,multiple calcified plaques in the proximal end of the circumflex branch and right coronary artery,and mild to moderate stenosis.The patient also developed diffuse atherosclerosis in the splenic and mesenteric arteries,with mild lumen stenosis and athero-sclerosis in the abdominal aorta and its branches.Endoscopy showed submucosal congestion and damage of the entire gastric mucosa,of which the fundus and body of the stomach were most seriously affected.The mucosa was swollen,with a deep purple color,surface erosion and dark red oozing blood.Pathological examination showed bleeding and necrosis of the gastric mucosa,with residual contours of the gastric glands,consistent with ischemic gastritis.CONCLUSION Ischemic gastritis is a rare disease that may be difficult to diagnose as its symptoms may be similar to those of other gastrointestinal diseases.Diagnosis is usually based on endoscopic and pathological examinations,which show insufficient blood supply to the gastric mucosa leading to mucosal damage and necrosis.展开更多
Adipose tissue-deried stem cells( ADSCs) are adult stem cells that can be easily harvested from subcutaneous adipose tissue. Many studies have demonstrated that ADSCs differentiate into vascular endothelial cells(VECs...Adipose tissue-deried stem cells( ADSCs) are adult stem cells that can be easily harvested from subcutaneous adipose tissue. Many studies have demonstrated that ADSCs differentiate into vascular endothelial cells(VECs), vascular smooth muscle cells(VSMCs), and cardiomyocytes in vitro and in vivo. However, ADSCs may fuse with tissue-resident cells and obtain the corresponding characteristics of those cells. If fusion occurs, ADSCs may express markers of VECs, VSMCs, and cardiomyocytes without direct differentiation into these cell types. ADSCs also produce a variety of paracrine factors such as vascular endothelial growth factor, hepatocyte growth factor, and insulin-like growth factor-1 that have proangiogenic and/or antiapoptotic activities. Thus, ADSCs have the potential to regenerate the cardiovascular system via direct differentiation into VECs, VSMCs, and cardiomyocytes, fusion with tissueresident cells, and the production of paracrine factors. Numerous animal studies have demonstrated the efficacy of ADSC implantation in the treatment of acute myocardial infarction(AMI), ischemic cardiomyopathy(ICM), dilated cardiomyopathy, hindlimb ischemia, and stroke. Clinical studies regarding the use of autologous ADSCs for treating patients with AMI and ICM have recently been initiated. ADSC implantation has been reported as safe and effective so far. Therefore, ADSCs appear to be useful for the treatment of cardiovascular disease. However, the tumorigenic potential of ADSCs requires careful evaluation before their safe clinical application.展开更多
Brain magnetic resonance imaging （MRI） of the elderly often reveals white matter changes （WMCs） with substantial variability across individuals. Our study was designed to explore MRI features and site-specific fac...Brain magnetic resonance imaging （MRI） of the elderly often reveals white matter changes （WMCs） with substantial variability across individuals. Our study was designed to explore MRI features and site-specific factors of ischemic WMCs. Clinical data of consecutive patients diagnosed with ischemic cerebral vascular disease who had undergone brain MRI were collected and analyzed. Multi-logistic regression analysis comparing patients with mild versus severe WMCs was performed to detect independent associations. Analyses of variance （ANOVAs） were used to detect regionally specific differences in lesions. We found that lesion distribution differed significantly across five cerebral areas, with lesions being predominant in the frontal lobe and parieto-occipital area. To explore WMCs risk factors, after adjusting for gender, diabetes mellitus, and hypertension, only age （P〈0.01）, creatinine （P=0.01）, alkaline phosphatase （ALP） （P=0.01） and low-density lipoprotein cholesterol （LDL-C） （P=0.03） were found to be independently associated with severe WMCs. Age （P〈0.001） was strongly associated with WMCs in the frontal lobe while hypertension was independently related to lesions in the basal ganglia （P=0.048） or infratentorial area （P=0.016）. In conclusion, MRI of WMCs showed that ischemic WMCs occurred mostly in the frontal lobe and parieto-occipital area. The infratentorial area was least affected by WMCs. Typically, age-related WMCs were observed in the frontal lobes, while hypertension-related WMCs tended to occur in the basal ganglia and infratentorial area.展开更多
背景:血管再生为缺血性脑卒中发病后重要的修复过程之一,因此二者之间的可视化分析极其必要。目的:基于文献计量学分析近10年来缺血性脑卒中与血管再生研究的相关文献,梳理该领域的研究现状、热点及未来发展趋势。方法:应用文献计量学方...背景:血管再生为缺血性脑卒中发病后重要的修复过程之一,因此二者之间的可视化分析极其必要。目的:基于文献计量学分析近10年来缺血性脑卒中与血管再生研究的相关文献,梳理该领域的研究现状、热点及未来发展趋势。方法:应用文献计量学方法,检索Web of Science(WoS)数据库2011年1月至2023年5月期间缺血性脑卒中与血管再生的相关文献,获取的数据采用可视化软件VOSviewer从发文量、国家、关键词、机构、作者、引文、关键词等方面进行系统分析。结果与结论:经过检索筛选出了1484篇文章,发现缺血性脑卒中和血管再生之间的关系已成为了脑血管领域内新兴的研究热点,发文量持续上升。其中大多发文机构来自于中国与美国,文章被引用次数最高的机构是上海交通大学,最有影响力的作者是HERMANN DM,他的文章被引用了1003次,而细胞外囊泡、microRNA、间质干细胞与疾病之间的关系是这一领域内的研究热点。通过文献计量学分析为缺血性脑卒中及血管再生领域提供了可视化分析,发现此领域将是一个新兴的焦点,同时也为缺血性脑卒中和血管再生的研究要点和未来趋势提供了有益参考。展开更多
目的探讨脑小血管(cerebral small vessel disease,CSVD)负担评分对短暂性脑缺血发作(transient ischemic attack,TIA)患者复发性脑血管事件(recurrence cerebrovascular events,RCVEs)的预测价值。材料与方法回顾性分析2019年10月至202...目的探讨脑小血管(cerebral small vessel disease,CSVD)负担评分对短暂性脑缺血发作(transient ischemic attack,TIA)患者复发性脑血管事件(recurrence cerebrovascular events,RCVEs)的预测价值。材料与方法回顾性分析2019年10月至2022年12月期间于安徽省第二人民医院就诊的182例TIA患者病例资料,依据MRI检查计算CSVD总体负担评分,根据随访1个月内有无发生RCVEs分为RCVEs组(n=46)和未RCVEs组(n=136)。比较两组临床资料和CSVD总体负担评分,采用多因素logistic回归分析模型分析RCVEs的独立危险因素,绘制受试者工作特征(receiver operating characteristic,ROC)曲线分析CSVD影像特征得分及总负担评分对TIA患者RCVEs的预测价值。结果RCVEs组和未RCVEs组TIA发作次数、症状持续时间、既往高血压病史、CSVD总负担评分及分级情况比较差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示:TIA发作次数、症状持续时间、CSVD总负担评分是TIA患者发生RCVEs的独立危险因素(P<0.05)。ROC曲线分析结果显示:CSVD影像特征评分及总负担评分预测TIA患者发生RCVEs的曲线下面积(areas under the curve,AUC)分别为0.771(95%CI:0.673~0.869,P<0.001)、0.745(95%CI:0.655~0.835,P<0.001)、0.664(95%CI:0.549~0.780,P=0.009)、0.845(95%CI:0.766~0.924,P<0.001)、0.945(95%CI:0.896~0.994,P<0.001),其中CVSD总负担评分预测的AUC最高,当最佳截断值为2分时,敏感度为86.05%,特异度为83.02%。结论CSVD总负担评分对TIA患者发生RCVEs的预测价值良好,有助于临床评估TIA患者的短期预后。展开更多
文摘Aim YiQiFuMai Powder Injection is a well-known traditional Chinese medicine formula that has been used extensively in clinical treatment of cardio-cerebral ischemic diseases in China. However, the mechanisms under-lying its clinical efficacy remain unknown. In this study, a network pharmacology approach was employed to identify the YiQiFuMai Powder Injection＇s potential pathways and targets against cardio-cerebral ischemia. The target-path- way interaction network clustered the signaling pathways based on high degree nodes of the drug-target network. The potential protein targets presented in the highly scored clustered pathways were the key network hubs and concentrated on one or limited functional signaling pathways amenable to experimental verification. Twelve main functional annota- tion clusters and main signaling pathways for YiQiFuMai Powder Injection were established by Biocarta analysis, in- eluding the NF-KB signaling pathway, the MAPKinase signaling pathway and the mTOR-signaling pathway and so on. YiQiFuMai Powder Injection is hypothesized to target multiple proteins with a high degree and betweenness of net- work. In addition, the most related pathways were also confirmed in tumor necrosis factor-alpha （TNF-oL） induced human vascular endothelial cell line EA. hy926 by Western blot. This study elucidates the systematic network and pathway analysis of multi-targets in YiQiFuMai Powder Injection. The results provide the possible mechanisms for its mode of action against cardio-cerebral ischemic diseases and may also reveal new clues for its potential application in the inflammatory diseases or tumors.
基金National Natural Science Foundation of China(81603385)China Postdoctoral Science Foundation(2018M643843)+1 种基金Natural Science Foundation of Shaanxi Province(2017JM8056)Key Research and Development Foundation of Shaanxi province(2018SF-241)
文摘OBJECTIVE Numerous references made clear that triphala is revered as a multiuse therapeutic and perhaps even panacea historically.Nevertheless,the protective mechanism of triphala on cardio-cerebral vascular diseases(CCVDs)remains not comprehensive understanding.Hence,a network pharmacology-based method was suggested in this study to address this problem.METHODS This study was based on network pharmacology and bioinformatics analysis.Information on compounds in herbal medicines of triphala formula was acquired from public databases.Oral bioavailability as well as drug-likeness were screened by using absorption,distribution,metabolism,and excretion(ADME)criteria.Then,components of triphala,candidate targets of each component and known therapeutic targets of CCVDs were collected.Compound-target gene and compounds-CCVDs target networks were created through network pharmacology data sources.In addition,key targets and pathway enrichment were analyzed by STRING database and DAVID database.Moreover,we verified three of the key targets(PTGS2,MMP9 and IL-6)predicted by using Western blotting analysis.RESULTS Network analysis determined 132 compounds in three herbal medicines that were subjected to ADME screening,and 23 compounds as well as 65 genes formed the principal pathways linked to CCVDs.And 10 compounds,which actually linked to more than three genes,are determined as crucial chemicals.Core genes in this network were IL-6,TNF,VEGFA,PTGS2,CXCL8,TP53,CCL2,IL-10,MMP9 and SERPINE1.And pathways in cancer,TNF signaling path⁃way,neuroactive ligand-receptor interaction,etc.related to CCVDs were identified.In vitro experiments,the results indi⁃cated that compared with the control group(no treatment),PTGS2,MMP9 and IL-6 were up-regulated by treatment of 10μg·L^-1 TNF-α,while pretreatment with 20-80 mg·L^-1 triphala could significantly inhibit the expression of PTGS2,MMP9 and IL-6.With increasing Triphala concentration,the expression of PTGS2,MMP9 and IL-6 decreased.CON⁃CLUSION Complex components and pharmacological mechanism of triphala,and obtained some potential therapeutic targets of CCVDs,which could provide theoretical basis for the research and development of new drugs for treating CCVDs.
文摘Respiratory disease and cardio-cerebral vascular disease frequently occur in Anyang City. In this paper, by comparing incidence num- bers of respiratory disease and cardio-cerebral vascular disease in Anyang People＇s Hospital during 2010 -2012 with seasonal change of local tem- perature,it is found that they have obvious relationship, which has very important significance for preventing respiratory disease and cardio-cerebral vascular disease in the future.
文摘With the progress in global demography of aging, dementia has become a great world health-care issue that require urgent attention and settlement. Demen-tia can arise from a variety of factors, such as neuronal degeneration for Alzheimer’s disease （AD）, vascular risk factors and multiple infarcts for vascular dementia （VaD）, and both degeneration and vascular factors for mixed de-mentia （MD）. Pathophysiology of AD includes the amy-loid and tau protein hypothesis, and infammation-related mechanisms are also widespread mentioned. Subcortical ischemic vascular dementia （SIVD）, a subtype of VaD, is commonly caused by complete or incomplete lacunar infarction of VaD pathology. MD involves both degenera-tion and vascular factors, and the interaction between the two results in the complication of the pathological mech-anism and clinical phenotype. The clinical manifestationsof AD are often divided into four stages according to the progress of the disease, while the phenotypes of SIVD usually has two categories. As for MD, the phenotypes are complex and diverse. Several clinical studies showedthat its symptoms and signs are more similar to SIVD than AD. This article aims to analyze and compare the differ-ent aspects of the three kinds of dementia.
文摘BACKGROUND Ischemic gastritis is a clinically rare disease with high mortality that infrequently reported in the medical literature and under-recognized clinically and histopatho-logically.Early diagnosis and treatment can only be achieved through upper gastrointestinal endoscopy after symptoms appear.CASE SUMMARY A 68-year-old woman with a history of intracranial aneurysm developed dizziness,chest tightness and unconsciousness for 2 d.Computed tomography angiography showed diffuse coronary atherosclerosis,moderate to severe stenosis in the proximal end of the left anterior descending branch,multiple calcified plaques in the proximal end of the circumflex branch and right coronary artery,and mild to moderate stenosis.The patient also developed diffuse atherosclerosis in the splenic and mesenteric arteries,with mild lumen stenosis and athero-sclerosis in the abdominal aorta and its branches.Endoscopy showed submucosal congestion and damage of the entire gastric mucosa,of which the fundus and body of the stomach were most seriously affected.The mucosa was swollen,with a deep purple color,surface erosion and dark red oozing blood.Pathological examination showed bleeding and necrosis of the gastric mucosa,with residual contours of the gastric glands,consistent with ischemic gastritis.CONCLUSION Ischemic gastritis is a rare disease that may be difficult to diagnose as its symptoms may be similar to those of other gastrointestinal diseases.Diagnosis is usually based on endoscopic and pathological examinations,which show insufficient blood supply to the gastric mucosa leading to mucosal damage and necrosis.
文摘Adipose tissue-deried stem cells( ADSCs) are adult stem cells that can be easily harvested from subcutaneous adipose tissue. Many studies have demonstrated that ADSCs differentiate into vascular endothelial cells(VECs), vascular smooth muscle cells(VSMCs), and cardiomyocytes in vitro and in vivo. However, ADSCs may fuse with tissue-resident cells and obtain the corresponding characteristics of those cells. If fusion occurs, ADSCs may express markers of VECs, VSMCs, and cardiomyocytes without direct differentiation into these cell types. ADSCs also produce a variety of paracrine factors such as vascular endothelial growth factor, hepatocyte growth factor, and insulin-like growth factor-1 that have proangiogenic and/or antiapoptotic activities. Thus, ADSCs have the potential to regenerate the cardiovascular system via direct differentiation into VECs, VSMCs, and cardiomyocytes, fusion with tissueresident cells, and the production of paracrine factors. Numerous animal studies have demonstrated the efficacy of ADSC implantation in the treatment of acute myocardial infarction(AMI), ischemic cardiomyopathy(ICM), dilated cardiomyopathy, hindlimb ischemia, and stroke. Clinical studies regarding the use of autologous ADSCs for treating patients with AMI and ICM have recently been initiated. ADSC implantation has been reported as safe and effective so far. Therefore, ADSCs appear to be useful for the treatment of cardiovascular disease. However, the tumorigenic potential of ADSCs requires careful evaluation before their safe clinical application.
基金This work was supported by grants from Scientific Research Project of Health and Family Planning of Hubei Province （No. WJ2015MB056）, Natural Science Foundation of Hubei Province （No. 2015CFB572）, and Clinical Research Physician Program of Tongji Medical College, HUST.
文摘Brain magnetic resonance imaging （MRI） of the elderly often reveals white matter changes （WMCs） with substantial variability across individuals. Our study was designed to explore MRI features and site-specific factors of ischemic WMCs. Clinical data of consecutive patients diagnosed with ischemic cerebral vascular disease who had undergone brain MRI were collected and analyzed. Multi-logistic regression analysis comparing patients with mild versus severe WMCs was performed to detect independent associations. Analyses of variance （ANOVAs） were used to detect regionally specific differences in lesions. We found that lesion distribution differed significantly across five cerebral areas, with lesions being predominant in the frontal lobe and parieto-occipital area. To explore WMCs risk factors, after adjusting for gender, diabetes mellitus, and hypertension, only age （P〈0.01）, creatinine （P=0.01）, alkaline phosphatase （ALP） （P=0.01） and low-density lipoprotein cholesterol （LDL-C） （P=0.03） were found to be independently associated with severe WMCs. Age （P〈0.001） was strongly associated with WMCs in the frontal lobe while hypertension was independently related to lesions in the basal ganglia （P=0.048） or infratentorial area （P=0.016）. In conclusion, MRI of WMCs showed that ischemic WMCs occurred mostly in the frontal lobe and parieto-occipital area. The infratentorial area was least affected by WMCs. Typically, age-related WMCs were observed in the frontal lobes, while hypertension-related WMCs tended to occur in the basal ganglia and infratentorial area.
文摘背景:血管再生为缺血性脑卒中发病后重要的修复过程之一,因此二者之间的可视化分析极其必要。目的:基于文献计量学分析近10年来缺血性脑卒中与血管再生研究的相关文献,梳理该领域的研究现状、热点及未来发展趋势。方法:应用文献计量学方法,检索Web of Science(WoS)数据库2011年1月至2023年5月期间缺血性脑卒中与血管再生的相关文献,获取的数据采用可视化软件VOSviewer从发文量、国家、关键词、机构、作者、引文、关键词等方面进行系统分析。结果与结论:经过检索筛选出了1484篇文章,发现缺血性脑卒中和血管再生之间的关系已成为了脑血管领域内新兴的研究热点,发文量持续上升。其中大多发文机构来自于中国与美国,文章被引用次数最高的机构是上海交通大学,最有影响力的作者是HERMANN DM,他的文章被引用了1003次,而细胞外囊泡、microRNA、间质干细胞与疾病之间的关系是这一领域内的研究热点。通过文献计量学分析为缺血性脑卒中及血管再生领域提供了可视化分析,发现此领域将是一个新兴的焦点,同时也为缺血性脑卒中和血管再生的研究要点和未来趋势提供了有益参考。
文摘目的探讨脑小血管(cerebral small vessel disease,CSVD)负担评分对短暂性脑缺血发作(transient ischemic attack,TIA)患者复发性脑血管事件(recurrence cerebrovascular events,RCVEs)的预测价值。材料与方法回顾性分析2019年10月至2022年12月期间于安徽省第二人民医院就诊的182例TIA患者病例资料,依据MRI检查计算CSVD总体负担评分,根据随访1个月内有无发生RCVEs分为RCVEs组(n=46)和未RCVEs组(n=136)。比较两组临床资料和CSVD总体负担评分,采用多因素logistic回归分析模型分析RCVEs的独立危险因素,绘制受试者工作特征(receiver operating characteristic,ROC)曲线分析CSVD影像特征得分及总负担评分对TIA患者RCVEs的预测价值。结果RCVEs组和未RCVEs组TIA发作次数、症状持续时间、既往高血压病史、CSVD总负担评分及分级情况比较差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示:TIA发作次数、症状持续时间、CSVD总负担评分是TIA患者发生RCVEs的独立危险因素(P<0.05)。ROC曲线分析结果显示:CSVD影像特征评分及总负担评分预测TIA患者发生RCVEs的曲线下面积(areas under the curve,AUC)分别为0.771(95%CI:0.673~0.869,P<0.001)、0.745(95%CI:0.655~0.835,P<0.001)、0.664(95%CI:0.549~0.780,P=0.009)、0.845(95%CI:0.766~0.924,P<0.001)、0.945(95%CI:0.896~0.994,P<0.001),其中CVSD总负担评分预测的AUC最高,当最佳截断值为2分时,敏感度为86.05%,特异度为83.02%。结论CSVD总负担评分对TIA患者发生RCVEs的预测价值良好,有助于临床评估TIA患者的短期预后。
