缺血性卒中患者左心室质量指数与颅内、外动脉狭窄的相关性

doi:10.3969/j.issn.1673-5765.2019.01.004

摘要/Abstract

摘要：

目的探讨左心室质量指数（left ventricular mass index，LVMI）与颅内外动脉粥样硬化狭窄程度的关系。方法从东部战区总医院南京卒中登记系统纳入2017年1-10月间进行超声心动图和DSA检查的缺血性卒中患者。对颅外和颅内动脉粥样硬化性狭窄程度进行评估，分为动脉轻度狭窄组和动脉中重度狭窄组。LVMI根据美国超声心动图协会标准计算。在颅外和颅内动脉粥样狭窄患者中分别比较动脉轻度狭窄和中重度狭窄组传统脑动脉粥样硬化的危险因素，如年龄、性别、高血压、糖尿病、冠状动脉硬化心脏病、血脂及左心室质量（left ventricular mass，LVM）和LVMI。单因素分析及二元回归分析影响颅内外动脉粥样硬化狭窄程度的独立危险因素并对LVMI与颅内外动脉狭窄率进行相关性分析。结果 169例登记患者中，85例（50.3%）为颅外动脉粥样硬化性狭窄，84例（49.7%）为颅内动脉粥样硬化狭窄。在颅外动脉粥样硬化性狭窄患者中，中重度狭窄患者年龄比轻度狭窄患者大 [（64.3±12.4）岁 vs（56.0±13.2）岁，P =0.001]，LVMI较轻度狭窄患者高[（43.6±10.3）g/m2.7 vs （36.6±7.2）g/m2.7，P <0.001]。在颅内动脉粥样硬化性狭窄患者中，轻度狭窄患者LVMI低于中重度狭窄患者（[ 36.5±7.2）g/m2.7 vs（46.1±13.6）g/m2.7，P <0.001]。Spearman相关分析结果表明LVMI与颅内外动脉狭窄率呈正相关（r=0.553，P<0.001）。二元回归分析发现LVM（I OR 1.13，95%CI 1.05～1.21）、年龄（OR 1.06，95%CI 1.01～1.11）是颅外动脉粥样硬化性重度狭窄的独立危险因素。结论缺血性卒中患者LVMI与颅内外动脉粥样硬化性狭窄率正相关，LVMI是颅外动脉粥样硬化性重度狭窄的独立危险因素。

文章导读： 本研究通过对急性缺血性卒中患者资料的回顾性分析显示，左心室质量和左心室质量指数与缺血性卒中患者颅内和颅外动脉粥样硬化性狭窄均有相关性。

关键词: 缺血性卒中; 左心室质量指数; 颅内动脉; 颅外动脉; 动脉粥样硬化性狭窄

Abstract:

Objective To evaluate the relationship between left ventricular mass index (LVMI) and cervicocerebral atherosclerotic stenosis. Methods Ischemic stroke patients with echocardiography and digital subtraction angiography (DSA) examination from Jinling hospital from January 2017 to October 2017 were enrolled in this study. The subjects were divided into mild and moderate-severe stenosis groups according to the degree of extra- and intracranial atherosclerotic stenosis. LVMI was calculated by the criteria of American Society of Echocardiography (ASE). The traditional risk factors of cerebral atherosclerosis such as age, gender, hypertension, diabetes, coronary artery disease, lipids, and left ventricular mass (LVM) and LVMI, were compared between the mild and moderate-severe stenosis group. Univariate analysis and bivariate regression analysis were performed to analyze the independent risk factors of cervicocerebral atherosclerotic stenosis and the correlation of LVMI and cervicocerebral stenosis degree. Results Among the 169 enrolled patients, 85 (50.3%) with extracranial atherosclerotic stenosis, and 84 (49.7%) with intracranial atherosclerotic stenosis. For patients with extracranial atherosclerotic stenosis, those with moderate-severe stenosis were older than whom with mild stenosis [(64.3±12.4) vs (56.0±13.2) years old, P =0.001], and the LVMI in moderate-severe stenosis group were higher than that in mild stenosis group[(43.6±10.3) vs (36.6±7.2) g/m2.7, P <0.001]. For patients with intracranial atherosclerotic stenosis, LVMI were lower in patients with mild stenosis than that in patients with moderate-severe stenosis [(36.5±7.2) vs (46.1±13.6), P <0.001]. Spearman correlation analysis showed that there was a positive correlation between LVMI and cervicocerebral stenosis rate (r =0.553, P <0.001). Bivariate logistic regression analysis showed that LVMI (OR 1.13, 95%CI 1.05-1.21), age (OR 1.06, 95%CI 1.01-1.11) were independent risk factors of severe extracranial atherosclerotic stenosis. Conclusions LVMI was positively correlated with cervicocerebral atherosclerotic stenosis in patients with ischemic stroke. LVMI was an independent risk factor of severe extracranial atherosclerotic stenosis.

Key words: Ischemic stroke; Left ventricular mass index; Extracranial artery; Intracranial artery; Atherosclerotic stenosis

赵敏，李顺，王猛猛，徐格林. 缺血性卒中患者左心室质量指数与颅内、外动脉狭窄的相关性[J]. 中国卒中杂志, 2019, 14(01): 23-28.

ZHAO Min, LI Shun, WANG Meng-Meng, XU Ge-Lin. Correlation between Left Ventricular Mass Index and Extra-and Intracranial Artery Stenosis in Ischemic Stroke Patients[J]. Chinese Journal of Stroke, 2019, 14(01): 23-28.

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