肱动脉内皮依赖性舒张功能障碍与非心源性缺血性卒中复发关系研究

目的 探讨肱动脉内皮依赖性舒张功能障碍与非心源性缺血性卒中一年复发关系的研究。 方法 本研究为前瞻性研究，连续收集青海省人民医院神经内科住院治疗的初发急性非心源性缺 血性卒中患者，依据超声测定血流介导的肱动脉舒张功能（flow mediated dilation，FMD）反应，将患者 分为3组：重度FMD受损组、轻度FMD受损组和FMD功能正常组，采集患者基线资料，入组12个月时对 患者进行随访，比较各组间缺血性卒中事件复发情况。 结果 研究期间共入组126例患者，完成随访123例，其中重度FMD受损组、轻度FMD受损组和FMD 功能正常组分别有25例、52例和46例。3组患者一年缺血性卒中复发率分别为8例（32.0%）、12例 （23.1%）、4例（8.7%）。FMD重度功能障碍组卒中复发率高于FMD功能正常组（P =0.016）。Logi sti c回 归分析显示糖尿病比值比（odds ratio，OR）3.657，95%可信区间（confidence interval，CI）1.135～11.777， P =0.030]，高血压（OR 3.286，95%C I 1.069～10.104，P =0.038），FMD重度受损（OR 6.155， 95%CI 1.333～28.420，P =0.020），C反应蛋白（C-reaction protein，CRP）（OR 1.053，95%CI 1.001～1.107， P =0.045）为非心源性卒中一年卒中复发的危险因素。 结论 FMD重度受损与缺血性卒中一年复发相关，且为卒中复发的独立危险因素。

Association between Brachial Artery Endothelium-dependent Vasodilatation Dysfunction and Reccurence of Non-cardiogenic Cerebral Ischemic Stroke

Objective To explore the relationship between brachial artery endothelium-dependent vasodilatation dysfunction and 1-year recurrence of non-cardiogenic cerebral ischemic stroke. Methods In our prospective observational study, patients with the ifrst acute non-cardioembolic ischemic stroke hospitalized in the Department of Neurology, The People's Hospital of QingHai Province were enrolled consecutively. According to lfow mediated diameter (FMD) percent change, these patients were divided into three groups: non-cardiac ischemic stroke combined with severe FMD damage group, non-cardiac ischemic stroke combined with mild FMD damage group, and pure non-cardiacischemic stroke group with normal FMD group. Then the baseline information were collected. The patients were followed up at 12th month. The amounts of ischemic stroke recurrence events and the influencing factors were compared with the results taken previously among different groups using Logistic regression analysis. Results A total of 126 patients were enrolled into study and 123 patients ifnished follow-up. Among which, 25 patients had severe FMD damage, 52 had mild FMD damage, and 46 had normal FMD. The recurrence rates of three groups after one year were as follows: 32.0% (n=8), 23.1% (n=12) and 8.7% (n=4), respectively. The statistics results showed that the number of non-cardiac ischemic stroke combined with severe FMD damage group's ischemic stroke recurrence events was signiifcant different compared with normal FMD group (P=0.016). According to the Logistic regression analysis, it showed that FMD severe damage (odds ratios OR] 6.155, 95% conifdence interval CI]
1.333~28.420,P=0.020), hypertension (OR 3.286, 95%CI 1.069~10.104,P=0.038), diabetes (OR 3.657, 95%CI 1.135~11.777,P=0.030), C-reaction protein (CRP) (OR 1.053, 95%CI 1.001~1.107,P=0.045) were related with the recurrence of ischemic stroke, which were also the independent risk factors at the same time. Conclusion Severe FMD damage is associated with 1-year recurrence of ischemic stroke and is the independent risk factor for the recurrence of stroke.