摘要
目的探究临床因素与生化指标对单侧大动脉粥样硬化型大脑中动脉闭塞(MCAO)侧枝形成的影响,为其治疗提供依据。方法选择2016年2月—2019年9月于苍南县人民医院神经内科住院治疗的单侧大动脉粥样硬化型MCAO患者198例作为研究对象,根据侧枝形成的情况将其分为侧枝良好组(GC组)和侧枝不良组(PC组),比较2组患者的基线资料、用药资料以及生化检验等,采用多因素logistic回归分析影响单侧大动脉粥样硬化型MCAO侧枝形成的相关因素。结果GC组48例,PC组150例。GC组高密度脂蛋白(HDL)水平为(1.21±0.14)mmol/L,高于PC组[(0.94±0.11)mmol/L,t=13.810,P<0.05];GC组低密度脂蛋白(LDL)、同型半胱氨酸(Hcy)和空腹血糖(FBG)水平分别为(2.41±0.85)mmol/L、(11.52±4.20)mmol/L、(5.45±1.84)mmol/L,PC组上述指标分别为(2.93±0.89)mmol/L、(13.71±4.06)mmol/L、(6.02±1.39)mmol/L,差异有统计学意义(t值分别为3.560、3.226、2.276,均P<0.05)。GC组美国国立卫生研究院卒中量表(NIHSS)评分低于PC组(t=3.201,P<0.05),他汀类用药占比高于PC组(χ^(2)=6.406,P<0.05)。高血压、HDL、Hcy、NIHSS、他汀类药物是影响单侧大动脉粥样硬化型MCAO侧支循环形成的独立相关因素。结论使用他汀类药物、高HDL水平能够促进单侧大动脉粥样硬化型MCAO侧支循环的形成,高Hcy与NIHSS不利于侧枝良好建立。
Objective To explore the effect of clinical factors and biochemical indexes on the formation of unilateral large-artery atherosclerotic middle cerebral artery occlusion(MCAO)collaterals and to provide basis for its treatment.Methods A total of 198 unilateral aortic atherosclerotic patients with MCAO who were hospitalised in the Department of Neurology at Cangnan People’s hospital from February 2016 to September 2019 were selected as the research subjects.They were divided into the good collateral(GC)and poor collateral(PC)groups on the basis of the formation of collaterals.The baseline data,medication data and biochemical tests of the two groups were compared.Multivariate logistic regression analysis was used to analyse the independent factors that affected the formation of unilateral aortic MCAO collaterals.Results Forty-eight cases were included in the GC group,and 150 cases were included in the PC group.The high-density lipoprotein(HDL)level in the GC group was(1.21±0.14)mmol/L,which was higher than that in the PC group[(0.94±0.11)mmol/L,t=13.810,P<0.05];the low-density lipoprotein(LDL),homocysteine(Hcy)and fasting blood glucose levels in the GC group were(2.41±0.85)mmol/L,(11.52±4.20)mmol/L and(5.45±1.84)mmol/L,respectively,whereas those in the PC group were(2.93±0.89)mmol/L,(13.71±4.06)mmol/L and(6.02±1.39)mmol/L,respectively,and the difference was statistically significant(t=3.560,3.226,2.276,respectively,P<0.05).The National Institutes of Health Stoke Scale(NIHSS)in the GC group was lower than that in the PC group(t=3.201,P<0.05),and the proportion of statins was higher than that in the PC group(χ^(2)=6.406,P<0.05).Hypertension,HDL,Hcy,NIHSS and statins affected the formation of collateral circulation of unilateral large-artery atherosclerotic MCAO independently.Conclusion Statins and high HDL levels can promote the formation of unilateral aortic MCAO collateral circulation,but high Hcy level and high NIHSS are not conducive to good collateral establishment.
作者
廖照亮
董海燕
卢振产
LIAO Zhao-liang;DONG Hai-yan;LU Zhen-chan(Department of Neurology,Cangnan People’s Hospital,Wenzhou,Zhejiang 325800,China;不详)
出处
《中华全科医学》
2021年第1期59-61,共3页
Chinese Journal of General Practice
基金
浙江省医药卫生科技计划项目(2018RC070)。
关键词
大脑中动脉闭塞
单侧
大动脉硬化
侧枝
他汀类
Middle cerebral artery occlusion
Unilateral
Aortic sclerosis
Collateral
Statins
