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缺血性脑血管病患者动脉狭窄分布及危险因素分析

Analysis of distribution and the risk factors of arterial stenosis in patients with ischemic cerebrovascular dis-ease

摘要:

目的:探讨缺血性脑血管病患者动脉狭窄分布情况及影响其发生的相关危险性因素。方法将224例缺血性脑血管病患者根据 DSA 检查结果分组,其中未发现狭窄或轻度狭窄的患者为对照组(43例),其他分为单纯颅外狭窄组(41例)、单纯颅内狭窄组(93例)和颅内外合并狭窄组(47例)。分析患者实验室检查结果。设计问卷收集包括姓名、年龄、长期吸烟、长期饮酒、高血压和糖尿病等影响因素指标。结果所有研究者中患有动脉狭窄的患者共181例。单因素分布情况显示:性别、年龄、长期吸烟、长期饮酒、高血压、糖尿病、高同型半胱氨酸、高溶血磷脂酸水平是造成脑动脉狭窄的独立危险因素(χ2/t =8.744、5.562、10.736、11.032、9.812、10.002、9.083、2.576,P<0.05)。多因素分析显示:高同型半胱氨酸、长期吸烟和饮酒都是单纯颅内动脉狭窄发生的危险因素;高同型半胱氨酸和高纤维蛋白原是单纯颅外狭窄的危险因素;年龄、高血压、长期吸烟和长期饮酒,及高同型半胱氨酸、高纤维蛋白原等因素都是颅内外合并狭窄发生的相关危险因素。结论缺血性脑血管病患者中以单纯颅内动脉狭窄最为多发。脑动脉狭窄的发生具有年龄特征,随着年龄的增大,颅外、颅内外合并动脉狭窄的发生率呈上升趋势。高同型半胱氨酸、长期吸烟和饮酒、高血压、糖尿病、高溶血磷脂酸是脑动脉狭窄的独立危险因素。

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Objective To investigate the distribution of arterial stenosis in patients with ischemic cerebrovas-cular disease and its risk factors .Methods 224 patients with ischemic cerebrovascular disease were divided into four groups according to DSA results .Patients showed no stenosis or mild stenosis were selected as control group ( 43 ca-ses),the other patients were divided into pure extracranial stenosis group (41 cases),simple intracranial stenosis group (93 cases) and extracranial stenosis group (47 cases).The results of laboratory test were analyzed .The ques-tionnaire was designed and the indicators including name ,age,long-term smoking,drinking,hypertension and diabetes were collected .Results Of all the subjects , there were 181 cases with artery stenosis .Single factor results showed that gender,age,long-term smoking,long-term drinking,hypertension,diabetes,high homocysteine,high level of lyso-phosphatidic acid were the independent risk factors of cerebral artery stenosis (χ2/t =8.744, 5.562, 10.736, 11.032,9.812,10.002,9.083,2.576,all P<0.05).Multivariate analysis showed that high homocysteine ,long-term smoking and drinking were the risk factors of simple intracranial artery stenosis .High homocysteine and high fibrino-gen were risk factors of simple extracranial stenosis .Age,hypertension,long-term smoking and drinking ,high homocys-teine and fibrinogen were risk factors of intracranial and extracranial stenosis .Conclusion In patients with ischemic cerebrovascular diseases ,the simple intracranial artery stenosis is most common .The incidence of cerebral artery ste-nosis has age characteristic ,with the increase of age ,the incidence rate of intracranial and extracranial artery stenosis is rising.High homocysteine,long-term smoking and drinking,hypertension,diabetes,high lysophosphatidic acid are independent risk factors of cerebral artery stenosis .

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