菲律宾缺血性脑卒中患者颅内动脉狭窄:单中心研究

Suzanne Marie Q. Ilagan-Gacita, Jennifer Ann P. Sanchez-Tapia, J. Navarro
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摘要

颅内动脉狭窄(ICAS)在某些种族中是常见的。它在亚洲人、西班牙裔美国人和非洲裔美国人中普遍存在,他们占世界人口的三分之二,使其成为世界上最常见的中风原因。目的:目的是描述ICAS患者的人口学数据、危险因素和1年预后。方法:连续收集经颅计算机断层扫描或磁共振成像、磁共振血管造影、计算机断层血管造影或经颅多普勒定期随访1年的缺血性脑卒中患者。同时收集无颅内狭窄的患者作为对照组。比较ICAS与大动脉粥样硬化(LAA)患者的人口学资料、危险因素、改良Rankin量表、卒中复发率和死亡率。估计狭窄闭塞病变的分布和程度。结果:共收集258例。109例为ICAS, 149例为LAA。男性62例(56.88%)。年龄分布:18 ~ 45岁,15岁(13.76%);46 ~ 60岁28例(25.69%);61岁及66岁以上(60.55%)。危险因素为高血压82例(75.23%)、糖尿病46例(42.20%)、高脂血症27例(24.77%)、房颤16例(14.68%)、既往卒中23例(21.10%)、饮酒28例(25.69%)、肥胖8例(7.34%)、脑血管家族史33例(30.28%)。ICAS位于大脑中动脉46(46.9%)、ICA 21(21.4%)、BA 11(11.2%)、VA 8(8.16%)、PCA 7(7.14%)、ACA 5(5.1%)。大多数患者表现为中度至重度狭窄。大多数患者的改良Rankin量表评分范围在0 ~ 2之间,与LAA患者比较差异不大。两组脑卒中复发率及病死率差异无统计学意义。结论:在本研究中,ICAS与LAA患者无明显差异。
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Intracranial Arterial Stenosis Among Filipino Ischemic Stroke Patients: A Single Center Study
Introduction: Intracranial arterial stenosis (ICAS) is common among certain race. It is prevalent in Asians, Hispanics, and African Americans, who constitutes about 2/3 of the world population making it the most common cause of stroke worldwide. Objectives: The objectives are to describe the demographic data and risk factors of patients with ICAS and 1-year outcome. Methods: Patients who had ischemic stroke by cranial computed tomography scan or magnetic resonance imaging, magnetic resonance angiography, computed tomographic angiography, or transcranial Doppler with periodic follow-up for 1 year were consecutively collected. Patients without intracranial stenosis were also collected and served as control. The demographic data, risk factors, modified Rankin Scale, stroke recurrence and mortality between ICAS and large artery atherosclerosis (LAA) patients were compared. The distribution and the degree of steno-occlusive lesions were estimated. Results: A total of 258 cases were consecutively collected. ICAS was demonstrated in 109 patients and 149 were LAA patients. There were 62 (56.88%) males. The age range distribution was as follows: 18 to 45 year olds, 15 (13.76%); 46 to 60 year olds, 28 (25.69%); and 61 year olds and above 66 (60.55%). Risk factors were hypertension 82 (75.23%), diabetes mellitus 46 (42.20%), hyperlipidemia 27 (24.77%), atrial fibrillation 16 (14.68%), history of previous stroke 23 (21.10%), alcohol drinker 28 (25.69%), obesity 8 (7.34%), and family history of cerebrovascular disease 33 (30.28%). ICAS was seen in the middle cerebral artery 46 (46.9%), ICA 21 (21.4%), BA 11 (11.2%), VA 8 (8.16%), PCA 7 (7.14%), and ACA 5 (5.1%). Majority of the patients showed moderate to severe stenosis. Modified Rankin Scale ranged from 0 to 2 in the majority of the patients and showed not much difference compared to LAA patients. The recurrence of stroke and death rate showed no significant difference between the 2 groups. Conclusion: In this study, no difference was seen between ICAS and LAA patients.
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