国际脑血管病杂志
國際腦血管病雜誌
국제뇌혈관병잡지
INTERNATIONAL JOURNAL OF CEREBROVASCULAR DISEASES
2013年
12期
886-891
,共6页
卒中%脑缺血%颈动脉疾病%钙质沉着症%体层摄影术,X线计算机%危险因素
卒中%腦缺血%頸動脈疾病%鈣質沉著癥%體層攝影術,X線計算機%危險因素
졸중%뇌결혈%경동맥질병%개질침착증%체층섭영술,X선계산궤%위험인소
Stroke%Brain Ischemia%Carotid Artery Diseases%Calcinosis%Tomography,X-Ray Computed%Risk Factors
目的 探讨颈动脉钙化与缺血性卒中的关系.方法 回顾性收集急性缺血性卒中患者和同期住院的非急性卒中患者的人口统计学资料、血管危险因素和临床特征.所有患者均行64排螺旋CT检查,平扫数据被传入GE工作站,应用Smart积分软件评价颈动脉钙化情况.采用多变量logistic回归分析确定缺血性卒中的独立危险因素.采用受试者工作特征(receiver operator characteristic,ROC)曲线分析判断颈动脉钙化对急性缺血性卒中的预测价值.结果 共纳入86例急性缺血性卒中和89例非缺血性卒中患者(对照组).缺血性卒中组与对照组比较,除既往卒中史外,年龄、性别和血管危险因素均无显著性差异.缺血性卒中组钙化积分[(338.57±77.35)分对(147.79±64.52)分；t=4.065,P=0.045]、总钙化体积[(372.22±78.73) mm3对(197.27±61.12)mm3；t =4.740,P=0.031]和钙化质量[(70.33±13.83)mg对(32.44±12.27) mg;t =6.673,P=0.011]均显著性高于对照组.在缺血性卒中患者中,症状侧颈动脉的钙化积分[(335.50±85.95)分对(312.73±90.61)分；t=0.052,P=0.820]、总钙化体积[(357.91±88.93)mm3对(311.71±81.43)mm3;t =0.071,P=0.791]和钙化质量[(59.68±17.36)mg对(51.29±18.69)mg;t=1.716,P=0.192]与非症状侧无显著性差异.多变量logistic回归分析显示,颈动脉钙化积分[优势比(odds ratio,OR)4.963,95％可信区间(confidence interval,CI)5.932 ～ 18.994；P=0.019]、总钙化体积(OR 5.967,95％ CI3.940 ～ 14.993；P=0.015)和钙化质量(OR 6.815,95％ CI4.703 ～21.946；P=0.007)是缺血性卒中的独立危险因素.对颈动脉钙化积分进行ROC曲线分析显示,当颈动脉钙化积分为231.25分时对急性缺血性卒中具有预测价值,敏感性为85.4％,特异性为89.9％,阳性预测值87.1％,阴性预测值为89.1％,ROC曲线下面积为0.891(95％ CI 0.808 ～0.913,P=0.027).结论 颈动脉钙化为缺血性卒中的独立危险因素之一,颈动脉钙化积分对急性缺血性卒中有一定的预测价值.
目的 探討頸動脈鈣化與缺血性卒中的關繫.方法 迴顧性收集急性缺血性卒中患者和同期住院的非急性卒中患者的人口統計學資料、血管危險因素和臨床特徵.所有患者均行64排螺鏇CT檢查,平掃數據被傳入GE工作站,應用Smart積分軟件評價頸動脈鈣化情況.採用多變量logistic迴歸分析確定缺血性卒中的獨立危險因素.採用受試者工作特徵(receiver operator characteristic,ROC)麯線分析判斷頸動脈鈣化對急性缺血性卒中的預測價值.結果 共納入86例急性缺血性卒中和89例非缺血性卒中患者(對照組).缺血性卒中組與對照組比較,除既往卒中史外,年齡、性彆和血管危險因素均無顯著性差異.缺血性卒中組鈣化積分[(338.57±77.35)分對(147.79±64.52)分；t=4.065,P=0.045]、總鈣化體積[(372.22±78.73) mm3對(197.27±61.12)mm3；t =4.740,P=0.031]和鈣化質量[(70.33±13.83)mg對(32.44±12.27) mg;t =6.673,P=0.011]均顯著性高于對照組.在缺血性卒中患者中,癥狀側頸動脈的鈣化積分[(335.50±85.95)分對(312.73±90.61)分；t=0.052,P=0.820]、總鈣化體積[(357.91±88.93)mm3對(311.71±81.43)mm3;t =0.071,P=0.791]和鈣化質量[(59.68±17.36)mg對(51.29±18.69)mg;t=1.716,P=0.192]與非癥狀側無顯著性差異.多變量logistic迴歸分析顯示,頸動脈鈣化積分[優勢比(odds ratio,OR)4.963,95％可信區間(confidence interval,CI)5.932 ～ 18.994；P=0.019]、總鈣化體積(OR 5.967,95％ CI3.940 ～ 14.993；P=0.015)和鈣化質量(OR 6.815,95％ CI4.703 ～21.946；P=0.007)是缺血性卒中的獨立危險因素.對頸動脈鈣化積分進行ROC麯線分析顯示,噹頸動脈鈣化積分為231.25分時對急性缺血性卒中具有預測價值,敏感性為85.4％,特異性為89.9％,暘性預測值87.1％,陰性預測值為89.1％,ROC麯線下麵積為0.891(95％ CI 0.808 ～0.913,P=0.027).結論 頸動脈鈣化為缺血性卒中的獨立危險因素之一,頸動脈鈣化積分對急性缺血性卒中有一定的預測價值.
목적 탐토경동맥개화여결혈성졸중적관계.방법 회고성수집급성결혈성졸중환자화동기주원적비급성졸중환자적인구통계학자료、혈관위험인소화림상특정.소유환자균행64배라선CT검사,평소수거피전입GE공작참,응용Smart적분연건평개경동맥개화정황.채용다변량logistic회귀분석학정결혈성졸중적독립위험인소.채용수시자공작특정(receiver operator characteristic,ROC)곡선분석판단경동맥개화대급성결혈성졸중적예측개치.결과 공납입86례급성결혈성졸중화89례비결혈성졸중환자(대조조).결혈성졸중조여대조조비교,제기왕졸중사외,년령、성별화혈관위험인소균무현저성차이.결혈성졸중조개화적분[(338.57±77.35)분대(147.79±64.52)분；t=4.065,P=0.045]、총개화체적[(372.22±78.73) mm3대(197.27±61.12)mm3；t =4.740,P=0.031]화개화질량[(70.33±13.83)mg대(32.44±12.27) mg;t =6.673,P=0.011]균현저성고우대조조.재결혈성졸중환자중,증상측경동맥적개화적분[(335.50±85.95)분대(312.73±90.61)분；t=0.052,P=0.820]、총개화체적[(357.91±88.93)mm3대(311.71±81.43)mm3;t =0.071,P=0.791]화개화질량[(59.68±17.36)mg대(51.29±18.69)mg;t=1.716,P=0.192]여비증상측무현저성차이.다변량logistic회귀분석현시,경동맥개화적분[우세비(odds ratio,OR)4.963,95％가신구간(confidence interval,CI)5.932 ～ 18.994；P=0.019]、총개화체적(OR 5.967,95％ CI3.940 ～ 14.993；P=0.015)화개화질량(OR 6.815,95％ CI4.703 ～21.946；P=0.007)시결혈성졸중적독립위험인소.대경동맥개화적분진행ROC곡선분석현시,당경동맥개화적분위231.25분시대급성결혈성졸중구유예측개치,민감성위85.4％,특이성위89.9％,양성예측치87.1％,음성예측치위89.1％,ROC곡선하면적위0.891(95％ CI 0.808 ～0.913,P=0.027).결론 경동맥개화위결혈성졸중적독립위험인소지일,경동맥개화적분대급성결혈성졸중유일정적예측개치.
Objective To investigate the relationship between carotid artery calcification and ischemic stroke.Methods The demographic data,vascular risk factors and clinical features of patients with acute ischemic stroke and non-acute stroke patients admitted in the same period were collected retrospectively.All the patients received 64-slice spiral CT examination,and the scan data were transmitted to a GE workstation.A smart score software was used to evaluate carotid artery calcification.Multivariate logistic regression analysis was used to identify the independent risk factors for ischemic stroke.Receiver operator characteristic (ROC) curve was used to analyze and determine the predictive value of carotid artery calcification in acute ischemic stroke.Results A total of 86 patients with acute ischemic stroke and 89 with non-acute stroke (control group) were enrolled.In addition to the previous stroke history,there were no significant differences in age,gender,and vascular risk factors between the ischemic stroke group and the control group.The calcium score (338.57 ± 77.35 vs.147.79 ± 64.52; t =4.065,P =0.045),total calcified volume (372.22 ± 78.73 mm3 vs.197.27 ±61.12 mm3; t =4.740,P =0.031),and calcification quality (70.33 ± 13.83 mg vs.32.44 ± 12.27 mg; t =6.673,P =0.011) of the ischemic stroke group were significantly higher than those of the control group.In patients with ischemic stroke,there were no significant differences in the carotid artery calcification score (335.50 ± 85.95 vs.312.73 ± 90.61; t =0.052,P =0.820),total calcified volume (357.91 ± 88.93 mm3 vs.311.71 ± 81.43 mm3; t=0.071,P=0.791),and calcium quality (59.68± 17.36 mg vs.51.29 ± 18.69 mg; t =0.071,P =0.791) between the symptomatic sides and non-symptomatic sides.Multivariate logistic regression analysis showed that the carotid artery calcification score (odds ratio [OR] 4.963,95％ confidence interval [CI] 5.932-18.994; P=0.019),total calcified volume (OR 5.967,95％ CI 3.940-14.993; P =0.015),and calcium quality (OR 6.815,95％ CI 4.703-21.946; P =0.007) were the independent risk factors for ischemic stroke.The ROC curve analysis of carotid artery calcification score showed that when it was 231.25,it had a predictive value for acute ischemic stroke.The sensitivity was 85.4％,specificity was 89.9％,positive predictive value was 87.1％,and negative predictive value was 89.1％.The area under the ROC curve was 0.891 (95％ CI 0.808-0.913; P =0.027).Conclusions Carotid artery calcification is one of the independent risk factors for ischemic stroke.Carotid artery calcification score has some predictive value for acute ischemic stroke.
