脑梗死患者颅内血管狭窄的危险因素分析

目的分析脑梗死患者颅内血管狭窄的危险因素。方法对186例脑梗死患者行经颅多普勒超声检查,检测血尿酸和血脂包括总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、甘油三酯。结果血管狭窄组患者总胆固醇(5.04±1.23 mmol/L)和低密度脂蛋白胆固醇水平(2.99±1.01 mmol/L)均显著高于无狭窄组患者(分别为4.60±1.12 mmol/L和2.59±0.69 mmol/L,P<0.05);Pearson相关分析表明,颅内血管峡窄与高血压史(r=0.206,P=0.005)、糖尿病史(r=0.238,P=0.001)、总胆固醇(r=0.181,P=0.016)、低密度脂蛋白胆固醇(r=0.227,P=0.003)及尿酸(r=0.132,P=0.016)相关;Logistic回归分析表明,高血压、糖尿病、低密度脂蛋白胆固醇、尿酸进入回归方程,它们对颅内血管狭窄的OR值分别为2.345、2.554、1.764和1.006(P<0.05)。结论除高血压和糖尿病外,尿酸和低密度脂蛋白胆固醇亦是脑梗死患者颅内血管狭窄形成的独立危险因素。

Analysis of Risk Factors on Intracranial Vascular Stenosis in Patients with Cerebral Infarction

Aim To analyse risk factors of intracranial vascular stenosis in patients with cerebral infarction. Methods 186 patients with cerebral infarction were assessed by transcranial Doppler.Uric acid(UA) and lipids including total cholesterol(TC),low density lipoprotein cholesterol(LDLC),high density lipoprotein cholesterol(HDLC) and triglyceride(TG) were examined. Results TC(5.04±1.23 mmol/L) and LDLC(2.99±1.01 mmol/L) were significantly higher in patients of stenosis group compared with nonstenosis group(4.60±1.12 mmol/L and 2.59±0.69 mmol/L respectivly,P<0.05).Pearson analysis showed that intracranial vascular stenosis correlated with hypertension(r=0.206,P=0.005),diabetes(r=0.238,P=0.001),TC(r=0.181,P=0.016),LDLC(r=0.227,P=0.003) and UA(r=0.132,P=0.016).Significant independent predictors of intracranial vascular stenosis by multivariate analysis included hypertension(OR=2.345,P=0.026),diabetes(OR=2.554,P=0.024),LDLC(OR=1.764,P=0.009) and UA(OR=1.006,P=0.007). Conclusions Except for hypertension and diabetes,UA and LDLC might be independent predictors of intracranial vascular stenosis in patients with cerebral infarction.