中国卒中杂志2018，Vol.13Issue(3)：226-231,6.DOI:10.3969/j.issn.1673-5765.2018.03.006
大脑中动脉分布区缺血性卒中患者的临床和影像学特征及复发危险因素
Clinical and Imaging Features of Ischemic Stroke in Middle Cerebral Artery Territory and Risk Factors for Recurrence
摘要
Abstract
Objective To analyze the clinical and imaging features of noncardiogenic Ischemic Stroke (IS) in middle cerebral artery (MCA) territory, and risk factors of recurrent IS. Methods Noncardiogenic IS patients in MCA territory with onset of symptoms <7 days were enrolled consecutively. Demographic information, risk factors for vascular diseases, main admission symptoms and signs, topographical distribution of acute infarcts, number and topographical distribution of acute infarcts, and stenosis degree of responsible MCA were assessed. Multivariate logistic regression analysis was used to identify risk factors associated with recurrent IS or TIA within the year following IS. Results A total of 926 patients were enrolled into study. Patients (n=447) with ≥70% degree stenosis in MCA most often had multiple acute infarcts (n=338, 75.6%) and watershed infarcts (n=317, 70.9%), while patients (n=479) without obvious stenosis or with <70% degree stenosis in MCA most often had single infarct (n=247, 55.3%) in the territory of MCA penetrating artery. Multivariate Logistic regression analysis identified history of coronary heart disease [odds ratio (OR) 7.55, 95% confidence interval(CI)2.85-20.0,P<0.001],history of IS(OR 3.49,95% CI 1.52-8.01,P=0.003),repeated TIAs within 3 months before the stroke(OR 22.7,95% CI 8.35-61.6,P<0.001),and newly onset multiple acute infarcts(OR 5.26,95% CI 1.33-20.8,P=0.018)as independent predictors of recurrent IS or TIA. Conclusion For patients with noncardiogenic IS, topographical distribution of acute infarcts is related with stenosis degree in MCA, and patients with multiple acute infarcts and history of ischemic cardiovascular or cerebrovascular disease had a higher recurrence risk of IS or TIA within 1 year.关键词
缺血性卒中/大脑中动脉/复发/危险因素Key words
Ischemic stroke/Middle cerebral artery/Recurrence/Risk factors引用本文复制引用
张长青,王伊龙,王春雪,刘丽萍,赵性泉,王拥军..大脑中动脉分布区缺血性卒中患者的临床和影像学特征及复发危险因素[J].中国卒中杂志,2018,13(3):226-231,6.基金项目
北京市优秀人才培养资助(青年骨干个人)-急性缺血性卒中的头颅磁共振影像学表现及影响预后的相关因素分析(2016000021469G215) （青年骨干个人）
