急性脑梗死患者大脑中动脉粥样硬化性重度狭窄的相关危险因素分析

<正>最近研究显示大脑中动脉深穿支合并皮层支和分水岭梗死的患者中94.40%存在相关供血动脉狭窄,重度狭窄的患者高达77.80%;直径小于或等于3.20cm单发深穿支梗死患者中18.40%存在相关供血动脉狭窄,重度狭窄的患者为1.10%。两组患者

With Severe Middle Cerebral Artery Stenosis Attributed to Atherosclerosis.

Objective To explore the risk factors attributed to atherosclerosis in patients with acute ischemic stroke with severe middle cerebral artery stenosis. Methods We consecutively collected retrospectively the clinical data of patients with acute ischemic stroke stay at the First Affiliated Hospital of Wenzhou Medical College from February 2007 to January 2010. We classified the patients with both concomitant perforator and pial or border-zone infarcts and stenosis ≥ 70% of related middle cerebral artery as the case group, and the patients with single perforator infarct with diameter ≤ 3.20cm and the related cerebral artery without stenosis and the stenosis ≤30% of related carotid as control group. We compared the risk factors of the two groups with single factor analysis and non-conditional logistic regression analysis. Results 189 cases were enrolled, with 51 patients in case group and 138 cases in control group. The independent variables associated with the moderate stenosis attributed to atherosclerosis in acute ischemic stroke were high density lipaprotein（OR = 2.62,95% CI = 1.30- 5.25, P = 0.01） and creatinine（ OR = 3.53,95% CI = 1.76 - 7.09, P = 0.00）. Conclusions Low levels of high density lipoprotein is a main risk factor for middle cerebral artery stenosis attributed to atherosclerosis in acute ischemic stroke and low levels of creatinine may be also one of the risk factors for middle cerebral artery stenosis attributed to atherosclerosis.