Clinical distribution characteristics and analysis on risk factors of extracranial carotid artery stenosis in patients with acute ischemic stroke

Li Jing; Tian Ting; Shi Zhenghong; Feng Bin

doi:10.13406/j.cnki.cyxb.000929

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Clinical distribution characteristics and analysis on risk factors of extracranial carotid artery stenosis in patients with acute ischemic stroke

更新时间：2024-01-17

- Clinical distribution characteristics and analysis on risk factors of extracranial carotid artery stenosis in patients with acute ischemic stroke
- Journal of Chongqing Medical University Vol. 41, Issue 8, Pages: 864-868(2016)
- 作者机构：
  
  兰州大学第二医院神经内科
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.000929
  CLC： R743.3
- Published：2016，
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[1]栗静,田婷,石正洪,冯斌.急性缺血性卒中颅外颈动脉狭窄临床分布特点及危险因素分析[J].重庆医科大学学报,2016,41(08):864-868.

Li Jing, Tian Ting, Shi Zhenghong, et al. Clinical distribution characteristics and analysis on risk factors of extracranial carotid artery stenosis in patients with acute ischemic stroke. [J]. Journal of Chongqing Medical University 41(8):864-868(2016)
[1]栗静,田婷,石正洪,冯斌.急性缺血性卒中颅外颈动脉狭窄临床分布特点及危险因素分析[J].重庆医科大学学报,2016,41(08):864-868. DOI： 10.13406/j.cnki.cyxb.000929.

Li Jing, Tian Ting, Shi Zhenghong, et al. Clinical distribution characteristics and analysis on risk factors of extracranial carotid artery stenosis in patients with acute ischemic stroke. [J]. Journal of Chongqing Medical University 41(8):864-868(2016) DOI： 10.13406/j.cnki.cyxb.000929.

摘要

目的:分析急性缺血性卒中（acute ischemic stroke

AIS）颅外颈动脉狭窄（extracranial carotid artery stenosis

ECAS）的发生率及其在急性卒中Org 10172治疗试验（trial of Org 10172 in acute stroke treatment

TOAST）各亚型中的分布特点

并探讨其危险因素。方法:连续收集本院神经内科2014年3月至2015年2月收治的375例AIS患者的临床资料

依照TOAST分型标准分为5型

分析ECAS在AIS患者及其亚型中的分布规律;根据颈部血管超声检查结果将AIS患者分为ECAS组（n=81）和对照组（n=294）

比较2组患者的临床资料并进行多因素logistic回归分析。结果:AIS患者ECAS发生率为35.73%

其中中-重度狭窄率为21.60%

16.80%分布于大动脉粥样硬化（1arge artery atherosclerosis

LAA）型卒中

高于小动脉闭塞、心源性脑栓塞及其他病因型卒中

差异有统计学意义（P

0.01）;ECAS组年龄、糖尿病、高脂血症、颈动脉斑块及不稳定斑块的发生率高于对照组

差异有统计学意义（P

0.05）;多因素Logistic回归分析显示糖尿病（OR=1.782

95%CI=1.048

.029

P=0.033）、高脂血症（OR=1.824

95%CI=1.037

.208

P=0.037）、颈动脉斑块（OR=3.673

95%CI=2.014

.698

P=0.000）是AIS患者ECAS的独立危险因素。结论:AIS患者ECAS发生率较以往有所升高

其中中-重度ECAS在TOAST分型中主要分布于LAA型卒中;糖尿病、高脂血症和颈动脉斑块是AIS患者ECAS的独立危险因素。

Abstract

Objective:To investigate the incidence of extracranial carotid artery stenosis(ECAS)in patients with acute ischemic stroke(AIS)and its distribution characteristics in the trial of Org 10172 in acute stroke treatment(TOAST)subtypes

then to explore the risk factors for ECAS in AIS patients. Methods:Totally 375 patients with AIS admitted to the Department of Neurology in The Second Hospital of Lanzhou University from March 2014 to February 2015 were collected and were sub-classified into 5 subtypes according to the TOAST criteria. The distribution characteristics of ECAS among all AIS patients and its subtypes were analyzed. AIS patients were divided into ECAS group(n =81) and control group(n =294) based on the carotid artery ultrasound examination results. The clinical data of the two groups were compared and the multi-factor Logistic regression was used to analyze the risk factors for ECAS.Results:The incidence of ECAS in patients with AIS was 35.73%

with moderate-severe stenosis rate being 21.60%

and 16.80% of which was found in the large artery atherosclerosis(LAA)subtype. The moderate-severe ECAS rate was statistically higher in the LAA subtype than in the small artery occlusion

cardioembolism

and stroke of other determined etiology subtypes(P<0.01). The age and incidence of diabetes mellitus

hyperlipidemia

carotid artery plaque and unstable plaque were higher in ECAS group than in con trol group with statistically significant differences(P<0.05). The multi-factor Logistic regression analysis showed that the diabetes mellitus(OR=1.782

95%CI=1.048 to 3.029

P=0.033)

hyperlipidemia(OR=1.824

95%CI=1.037 to 3.208

P=0.037)and carotid artery plaque(OR=3.673

95%CI=2.014 to 6.698

P=0.000)were independent risk factors for ECAS in AIS patients. Conclusion:The incidence of ECAS in AIS patients is increased than before

and the moderate-severe ECAS mainly distributes in the LAA subtype among TOAST classification. Diabetes mellitus

hyperlipidemia and carotid artery plaque are independent risk factors for ECAS in patients with AIS.

关键词

卒中TOAST分型颈动脉狭窄危险因素颈部血管超声

Keywords

strokeTOAST classificationcarotid artery stenosisrisk factorscarotid artery ultrasound

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