摘要
Abstract
Objective To investigate the prevalence and prognosis of symptomatic intracranial atherosclerotic stenoses (sICAS) among patients with ischemic stroke in Tangshan.
<br> Methods Two hundred and thirty-one patients were included prospectively and consecutively with acute cerebral infarction or transient ischemic attack (TIA), who underwent computed tomography angiography (CTA). According to the distribution of the different vascular lesions, all of patients were divided into two groups:the sICAS and the non-sICAS. Univariate and multivariate Logistic regression were used to analyze the inlfuence factors of the prognosis in patients with sICAS.
<br> Results In this study, we found that the prevalence of sICAS in in-patients with ischemic stroke was 46.8% (108/231). Univariate analyses showed that the National Institutes of Health Stroke Scale (NIHSS) scores at admission (odds ratio [OR] 0.872, 95%conifdence interval [CI] 0.775~0.980, P=0.022), hyperhomocysteinemia (OR 0.354, 95%CI 0.132~0.984, P=0.039) and anticoagulation therapy (OR 2.597, 95%CI 1.123~6.004, P=0.026) were associated with the favorable outcomes of sICAS patients at 6 months. Multivariate Logistic regression analyses demonstrated that the patients with severe arterial stenoses (OR 0.182, 95%CI 0.035~0.943, P=0.042) and occlusions (OR 0.156, 95%CI 0.029~0.833, P=0.021) had more poor outcomes than those with mild arterial stenoses, and the patients with high baseline NIHSS scores (OR 0.768, 95%CI 0.661~0.892, P=0.001) and hyperhomocysteinemia (OR 0.177, 95%CI 0.051~0.608, P=0.006) had worse prognoses, however, the patients receiving anticoagulative drug treatment (OR 7.714, 95%CI 2.440~24.389, P=0.001) had better outcomes at 6 months.
<br> Conclusion Nearly half of the in-patients with acute ischemic stroke have sICAS in Tangshan. High NIHSS scores at admission, arterial severe stenoses/occlusions, hyperhomocysteinemia are the predictors of unfavorable outcomes, whereas anticoagulation therapy is associated with favorable outcomes.关键词
颅内动脉粥样硬化性狭窄,症状性/急性缺血性卒中/预后Key words
Intracranial atherosclerosis, Symptomatic stenosis/Acute ischemic stroke/Prognosis
