中华神经医学杂志
中華神經醫學雜誌
중화신경의학잡지
CHINESE JOURNAL OF NEUROMEDICINE
2014年
6期
614-620
,共7页
周国强%曾进胜%黄宗青%刘洪涛%张娟
週國彊%曾進勝%黃宗青%劉洪濤%張娟
주국강%증진성%황종청%류홍도%장연
踝肱指数%脑卒中%亚型%动脉粥样硬化
踝肱指數%腦卒中%亞型%動脈粥樣硬化
과굉지수%뇌졸중%아형%동맥죽양경화
Ankle brachial index%Stroke%Subtype%Atherosclerosis
目的 通过分析脑卒中不同亚型中踝肱指数(ABI)的差异性,探讨ABI对脑卒中亚型的临床意义及对脑卒中分型的参考价值. 方法 选取深圳市福田区人民医院神经内科自2011年1月1日至2012年12月30日收治的475例脑卒中患者为研究对象,依据国内标准分为5个亚型(动脉粥样硬化性血栓性脑梗死组188例、腔隙性梗死组95例、心源性脑栓塞组73例、脑出血组85例、蛛网膜下腔出血组34例),同时收集同期因其他系统疾病住院的非脑卒中患者308例做为对照组.采用血管多谱勒超声测量仪检测入选患者ABI值.应用统计学方法分析各动脉粥样硬化危险因素(包括ABI)对脑卒中发生的影响,分析脑卒中不同亚型中ABI的差异,并在调整其他危险因素后单独评估ABI对脑卒中不同亚型的影响. 结果 (1)多因素Logistic回归分析显示,高血压(OR=3.963,95％置信区间2.128～6.982,P=0.0001)、糖尿病(OR=3.413,95％置信区间1.785～4.905,P=0.039)、吸烟(OR=2.216,95％置信区间1.942～6.025,P=0.020)和ABI (OR=2.425,95％置信区间1.405～3.512,P=0.012)与脑卒中发生存在统计学相关性.(2)动脉粥样硬化性血栓性脑梗死组、腔隙性梗死组、心源性脑栓塞组、脑出血组ABI与对照组比较差异有统计学意义(P=0.015、0.020、0.037、0.023).调整其他危险因素后,ABI与动脉粥样硬化性血栓性脑梗死(OR=2.832,95％置信区间1.776～5.273,P=0.011)、腔隙性梗死(OR=2.527,95％置信区间1.548～5.152,P=0.026)、心源性脑栓塞(OR=1.922,95％置信区间1.336～3.525,P=0.030)、脑出血(OR=2.332,95％置信区间1.243～4.165,P=0.021)存在负相关关系. 结论 ABI是脑卒中的重要独立危险因子;ABI可以作为血栓性脑梗死、腔隙性梗死、心源性脑栓塞、脑出血等脑卒中亚型的有效筛查指标.
目的 通過分析腦卒中不同亞型中踝肱指數(ABI)的差異性,探討ABI對腦卒中亞型的臨床意義及對腦卒中分型的參攷價值. 方法 選取深圳市福田區人民醫院神經內科自2011年1月1日至2012年12月30日收治的475例腦卒中患者為研究對象,依據國內標準分為5箇亞型(動脈粥樣硬化性血栓性腦梗死組188例、腔隙性梗死組95例、心源性腦栓塞組73例、腦齣血組85例、蛛網膜下腔齣血組34例),同時收集同期因其他繫統疾病住院的非腦卒中患者308例做為對照組.採用血管多譜勒超聲測量儀檢測入選患者ABI值.應用統計學方法分析各動脈粥樣硬化危險因素(包括ABI)對腦卒中髮生的影響,分析腦卒中不同亞型中ABI的差異,併在調整其他危險因素後單獨評估ABI對腦卒中不同亞型的影響. 結果 (1)多因素Logistic迴歸分析顯示,高血壓(OR=3.963,95％置信區間2.128～6.982,P=0.0001)、糖尿病(OR=3.413,95％置信區間1.785～4.905,P=0.039)、吸煙(OR=2.216,95％置信區間1.942～6.025,P=0.020)和ABI (OR=2.425,95％置信區間1.405～3.512,P=0.012)與腦卒中髮生存在統計學相關性.(2)動脈粥樣硬化性血栓性腦梗死組、腔隙性梗死組、心源性腦栓塞組、腦齣血組ABI與對照組比較差異有統計學意義(P=0.015、0.020、0.037、0.023).調整其他危險因素後,ABI與動脈粥樣硬化性血栓性腦梗死(OR=2.832,95％置信區間1.776～5.273,P=0.011)、腔隙性梗死(OR=2.527,95％置信區間1.548～5.152,P=0.026)、心源性腦栓塞(OR=1.922,95％置信區間1.336～3.525,P=0.030)、腦齣血(OR=2.332,95％置信區間1.243～4.165,P=0.021)存在負相關關繫. 結論 ABI是腦卒中的重要獨立危險因子;ABI可以作為血栓性腦梗死、腔隙性梗死、心源性腦栓塞、腦齣血等腦卒中亞型的有效篩查指標.
목적 통과분석뇌졸중불동아형중과굉지수(ABI)적차이성,탐토ABI대뇌졸중아형적림상의의급대뇌졸중분형적삼고개치. 방법 선취심수시복전구인민의원신경내과자2011년1월1일지2012년12월30일수치적475례뇌졸중환자위연구대상,의거국내표준분위5개아형(동맥죽양경화성혈전성뇌경사조188례、강극성경사조95례、심원성뇌전새조73례、뇌출혈조85례、주망막하강출혈조34례),동시수집동기인기타계통질병주원적비뇌졸중환자308례주위대조조.채용혈관다보륵초성측량의검측입선환자ABI치.응용통계학방법분석각동맥죽양경화위험인소(포괄ABI)대뇌졸중발생적영향,분석뇌졸중불동아형중ABI적차이,병재조정기타위험인소후단독평고ABI대뇌졸중불동아형적영향. 결과 (1)다인소Logistic회귀분석현시,고혈압(OR=3.963,95％치신구간2.128～6.982,P=0.0001)、당뇨병(OR=3.413,95％치신구간1.785～4.905,P=0.039)、흡연(OR=2.216,95％치신구간1.942～6.025,P=0.020)화ABI (OR=2.425,95％치신구간1.405～3.512,P=0.012)여뇌졸중발생존재통계학상관성.(2)동맥죽양경화성혈전성뇌경사조、강극성경사조、심원성뇌전새조、뇌출혈조ABI여대조조비교차이유통계학의의(P=0.015、0.020、0.037、0.023).조정기타위험인소후,ABI여동맥죽양경화성혈전성뇌경사(OR=2.832,95％치신구간1.776～5.273,P=0.011)、강극성경사(OR=2.527,95％치신구간1.548～5.152,P=0.026)、심원성뇌전새(OR=1.922,95％치신구간1.336～3.525,P=0.030)、뇌출혈(OR=2.332,95％치신구간1.243～4.165,P=0.021)존재부상관관계. 결론 ABI시뇌졸중적중요독립위험인자;ABI가이작위혈전성뇌경사、강극성경사、심원성뇌전새、뇌출혈등뇌졸중아형적유효사사지표.
Objective To investigate the differences of ankle-brachial index (ABI) in patients with stroke subtypes to explore the clinical significance of ABI in stroke subtypes.Methods Four hundred and seventy-five patients,admitted to our hospital from January 1,2011 to December 30,2012,were classified into the different stroke subtypes by standard of the fourth national cerebrovascular conference:188 patients with atherothrombotic infarction,95 with lacunar infarction,73 with cardiogenic cerebral embolism,85 with intracerebral hemorrhage and 34 with subarachnoid hemorrhage.The normal controls consisted of patients who had no cerebrovascular diseases.ABI was measured in all subjects with Doppler ultrasonic measurement.Statistical analysis was used to analyze the influences of atherosclerosis hazards (including ABI) in stroke,and the difference of ABI in different subtypes of stroke.After adjusting other risk factors,the influence of ABI in stroke subtypes was evaluated alone.Results (1)Multiple factor logistic regression analysis showed that hypertension (odds ratio [OR]=3.963,95％confidence interval[CI]:2.128-6.982,P=0.0001),diabetes mellitus (OR=3.413,95％CI:1.785-4.905,P=0.039),smoking (OR=2.216,95％CI:1.942-6.025,P=0.020),and ABI (OR=2.425,95％CI:1.405-3.512,P=0.012) were significantly correlated with the presence of stroke.(2) Analysis of variance showed that there were significant differences in ABI between the atherothrombotic infarction group and the normal control group (P=0.015),between the lacunar infarction group and the normal control group (P=0.020),between the cardiogenic cerebral embolism group and the normal control group (P=0.037),and between the intracerebral hemorrhage group and the normal control group (P=0.023).After adjusting the risk factors of stroke,disorder multi-classification Logistic regression analysis showed that ABI was negatively correlated to atherothrombotic infarction (OR=2.832,95％CI:1.776-5.273,P=0.011),lacunar infarction (OR=2.527,95％CI:1.548-5.152,P=0.026),cardiogenic cerebral embolism (OR=1.922,95％CI:1.336-3.525,P=0.030),and intracerebral hemorrhage (OR=2.332,95％CI:1.243-4.165,P=0.021).Conclusions ABI is independently and strongly related to the risk of stroke.ABI can serve as screening index of atherothrombotic infarction,lacunar infarction,cardiogenic cerebral embolism,and intracerebral hemorrhage.
