急性脑梗死患者动脉狭窄的分布特征和危险因素分析

目的探讨急性脑梗死患者的颅内外动脉狭窄分布的特征和相关危险因素。方法52例有症状性急性脑梗死患者行数字减影脑血管造影术，以判断颅内外动脉狭窄的特征，并比较狭窄组和非狭窄组患者的高血压、糖尿病、冠心病、吸烟、TIA病史、胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、脂蛋白a的情况和水平。使用Logistic回归分析以上与颅内外动脉狭窄有关的危险因素。结果52例患者中，35例（67．3％）有颅内外动脉狭窄，其中颅内动脉狭窄的有30例，动脉狭窄的发生率为85．7％，颅外动脉狭窄的有13例，动脉狭窄的发生率为37．1％。同时存在2条以上动脉狭窄的有20例，发生率为57．1％，双侧动脉狭窄的有15例，发生率为42．9％，既有前循环动脉狭窄又有后循环动脉狭窄的有8例，发生率为22．9％。Logistic回归分析显示，糖尿病（OR：3．5，95％CI：2．7～7．8；P=0．019）和高密度脂蛋白胆固醇降低（OR=1．5，95 CI：1．1—4．6；P=0．042）是颅内外动脉狭窄的独立危险因素。结论急性脑梗死患者颅内动脉狭窄的发生率高于颅外动脉狭窄的发生率，半数以上有多条动脉狭窄；糖尿病和高密度脂蛋白胆固醇降低与颅内外动脉狭窄有关。

Distribution characteristics of cerebral artery stenosis in patients with acute cerebral infarction and analysis of related risk factors

Objective To investigate the distribution characteristics and related risk factors of cerebral artery stenosis in patients with acute cerebral infarction. Methods Digital subtraction angiography （DSA） was performed in 52 patients with acute symptomatic cerebral infarction to identify the characteristics of intra-and extra-cranial arterial stenosis, The histories of hypertension, diabetes mellitus, coronary heart disease, smoking and transient ischemic attack （TIA） , and the levels of cholesterol, triglyeeride （ TG）, high-density lipoprotein cholesterol （ HDL-C ）, low-density lipoprotein （ LDL-C ） cholesterol, and lipoprotein （a） （Lpa） were compared between the cerebral artery stenosis group and the non-cerebral artery stenosis group. Logistic regression analysis was used to determine the above risk factors associated with cerebral artery stenosis. Results Thirty-five patients （67.3%） had cerebral artery stenosis. The incidence of intracranial artery stenosis （85. 7% ） was higher than that of extracranial artery stenosis （37. 1% ）. The incidence of muhipie artery stenosis was 57.1%. Logistic regression analysis suggested that diabetes mcllitus （OR =3.5, 95% CI 2.7 -7.8,P=0.019） and HDL-C （OR= 1.5, 95% CI 1.1 - 4.6,P = 0. 042 ） were the independent risk factors for cerebral artery stenosis. Conclusion The incidence of intraeranial artery stenosis in patients with acute cerebral infarction is higher than that of extracranial artery stenosis, and more than half of the patients have multiple artery stenosis. Diab. etes mellitus and HDL-C are associated with cerebral artery stenosis.