缺血性脑血管病颅内动脉狭窄的危险因素

目的研究缺血性脑血管病颅内动脉狭窄的危险因素.方法对503例缺血性脑血管病患者进行经颅多普勒超声检查,化验总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、甘油三酯、血浆肌酐.结果有高血压、糖尿病的缺血性脑血管病患者容易发生颅内动脉狭窄,颅内动脉狭窄更常见于既有高血压又有糖尿病者,三者的相对危险度、卡方值、P值分别为2.138、2.152、2.610,23.344、5.610、13.251,0.000、0.018、0.000.有卒中史者也容易发生颅内动脉狭窄,其卡方值、P值为4.299、0.038.颅内动脉狭窄组高密度脂蛋白胆固醇(1.00±0.17 mmol/L)比非狭窄组(1.20±0.12 mmol/L)低(P＜0.01),低密度脂蛋白胆固醇(3.55±0.67mmol/L)比非狭窄组(3.30±0.66mmol/L)高(P＜0.01).结论缺血性脑血管病颅内血管狭窄的危险因素有高血压、糖尿病、卒中史、低密度脂蛋白胆固醇增高等,保护因素有高密度脂蛋白胆固醇.

Risk factors of intracranial arterial stenosis in different patient types of ischemic stroke

Objective To investigate the risk factors of intracranial arterial stenosis in different patient types of ischemic stroke.Methods 503 patients with ischemic stroke were evaluated by using TCD. Lipids including total cholesterol (CHO), low-density lipoprotein cholesterol (LDL-C) and high- density lipoprotein cholesterol (HDL-C), triglyceride (TG)and creatinine were examined. Results Intracranial arterial stenosis in diabetes and non- diabetes groups, hypertension and non- hypertension groups showed significantly difference.The relative risk, ~2 and P value of the intracranial arterial stenosis influenced by hypertension and diabetes were 2.138, 2.152, 23.344, 5.610, 0.000, 0.018 respectively. The intracranial arterial stenosis was easily found in the patients with both hypertension and diabetes, the relative risk, ~2 and P value were 2.610, 13.251, 0.000. Intracranial arterial stenosis in stroke and non-stroke groups showed difference, the ~2 and P value were 4.299, 0.038.The patients with arterial stenosis had significantly higher low-density lipoprotein cholesterol (LDL-C) and lower high- density lipoprotein cholesterol (HDL-C) than those without stenosis. Conclusion Hypertension,diabetes,stroke history and LDL-C are associated with intracranial arterial stenosis in the patients with ischemic stroke. HDL-C are a protective factor.[