中老年缺血性卒中患者脑血管造影联合腹主动脉造影的影像学研究

目的：探讨中老年缺血性卒中患者发生脑血管狭窄和周围血管狭窄的影像学特点。方法：回顾性总结1060例在我科同期行脑血管造影和腹主动脉造影患者的检查结果，并记录可能引起动脉粥样硬化的相关参数，分析脑血管狭窄和周围血管狭窄的相关性，探索发生多支动脉狭窄和动脉溃疡性斑块的危险因素。结果：周围血管狭窄与脑血管狭窄有关(r=0.236，P<0.01)，且与脑血管狭窄的程度(r=0.228，P<0.01)和数量(r=0.231，P<0.01)呈正相关关系；年龄(OR=1.059，95% CI：1.015~1.117，P<0.05)、吸烟(OR=3.423，95% CI：1.524~7.780，P<0.01)及糖尿病(OR=3.651，95% CI：1.536~8.425，P<0.01)是多支动脉狭窄的危险因素。单因素分析未发现动脉溃疡性斑块的危险因素。结论：脑卒中患者往往合并有周围血管狭窄，对缺血性卒中患者脑血管造影同时联合腹主动脉造影具有重要意义；年龄、吸烟和糖尿病是多支动脉狭窄的独立危险因素。

Combination of cerebral angiography and abdominal angiography in patients with ischemic stroke

Objective: To explore the imaging characteristics of cerebral stenosis and peripheral vascular stenosis in patients withischemicstroke. Methods: The data collected from 1 060 patients with ischemic stroke, who were examined by cerebral angiography and abdominal angiography, were retrospectively analyzed. All relevant parameters for atherosclerosis were recorded. Then the correlation of cerebrovascular stenosis with peripheral vascular stenosis was analyzed, and the risk factors of multi-artery stenosis and ulcerative plaque were examined. Results: Peripheral vascular stenosis was closely correlated to cerebrovascular stenosis (r=0.236, P<0.01). The stenosis degree and quantity of cerebrovascular were positively correlated with peripheral vascular stenosis (r=0.228, P<0.01; r=0.231, P<0.01). The age (OR=1.059, 95% CI: 1.015–1.117; P<0.05), smoking (OR=3.423, 95% CI: 1.524–7.780; P<0.01) and diabetes (OR=3.651, 95% CI: 1.536–8.425; P<0.01) were risk factors for the occurrence of multi-artery stenosis. But the risk factor of ulcerative plaque was not found by single factor analysis. Conclusion: The cerebral angiography combined abdominal angiography is an effective method to identify cerebrovascular and peripheral vascular stenosis in the patients with stroke. Age, smoking and diabetes are independent risk factors for multi-artery stenosis in patients with ischemicstroke.