大动脉粥样硬化型脑梗死患者脑小血管病总体负担与颅内动脉狭窄的相关性

The Relationship between the Total Burden of Cerebral Small Vessel Disease and Intracranial Artery Stenosis in Patients with Large Atherosclerotic Cerebral Infarction

摘要: 目的：探讨大动脉粥样硬化型(Large Artery Atherosclerosis, LAA)脑梗死患者脑小血管病总体负担(The total CSVD score)与颅内动脉狭窄的相关性。方法：纳入2018年10月到2021年6月期间于我院神经内科住院，首次发生LAA型脑梗死患者228例。所有入组患者均完善颅脑MR及头颈部CTA检查；根据“总SVD评分法”将患者分为无/轻度组、中度组、重度组，根据“WASID方法”评估颅内血管狭窄情况，统计分析不同程度脑小血管病总体分担与颅内动脉狭窄程度之间的相关性。结果：1) LAA型脑梗死患者不同的脑小血管病总体负担评分组在年龄、高血压、高同型半胱氨酸等指标存在统计学差异(P < 0.05)。2) LAA型脑梗死患者脑小血管病总体负担与颅内动脉狭窄程度呈正相关。结论：LAA型脑梗死患者脑小血管病总体负担与颅内动脉狭窄呈正相关；高龄、高血压、高同型半胱氨酸水平为LAA型脑梗死患者脑小血管病总体负担影响因素。

Abstract: Objective: To investigate the relationship between the total burden of cerebral small vessel disease and intracranial artery stenosis in patients with large atherosclerotic cerebral infarction. Methods: A retrospective analysis was conducted on 228 patients, with large atherosclerotic cerebral infarction, who have completed magnetic resonance imaging and computed tomographic angiography and received treatment in Department of Neurology, the Affiliated Hospital of Qingdao University from October 2018 to June 2021. The “total SVD score method” was used to analyze the overall burden of cerebral small vessel disease. The patients were divided into no/mild group, moderate group, and severe group. The intracranial vascular stenosis was evaluated according to the “WASID method”. Analyze the relationship between the total burden of cerebral small vessel disease and intracranial artery stenosis in patients with large atherosclerotic cerebral infarction. Results: 1) There was a significant difference in the age, the prevalence of hypertension and homocysteine between the groups in the total burden of cerebral small vessel disease (P < 0.05), with statistical significance. 2) The overall burden score of cerebral small vessel disease was positively correlated with the severity of intracranial vascular stenosis, with statistical significance. Conclusion: The overall burden of cerebral small vessel disease is parallel to the degree of intracranial vascular stenosis in patients with large atherosclerotic cerebral infarction. Age, hypertension and homocysteine are the influencing factors of the overall burden of cerebral small vessel disease.